MRIDULA REVERI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036050634

License Status

NOT RENEWED

Business

First Name

MRIDULA

Last Name

REVERI

Business Name

MRIDULA REVERI

Original Issue Date

02/25/1975

Effective Date

06/02/2011

Expiration Date

07/31/2014

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/17/2014