ANNESLEY T DE VASGUNAWARDHANE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054736

License Status

INACTIVE

Business

First Name

ANNESLEY T DE

Last Name

VASGUNAWARDHANE

Suffix

Business Name

ANNESLEY T DE VASGUNAWARDHANE MD

Original Issue Date

06/09/1977

Effective Date

06/09/2011

Expiration Date

07/31/2014

City

CLIFTON

State

Zip

60927

County

IROQUOIS

Ever Disciplined

LastModifiedDate

04/08/2014

Case Number

1998011397

Action

Fine

Discipline Start Date

07/21/1999

Discipline Reason

Failed to provide a written response to the Department within sixty days of the Department's request. $1000 FINE DUE WITHIN 60 DAYS - PAID