SHANTHA K MONIPPALLIL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058112

License Status

NOT RENEWED

Business

First Name

SHANTHA

Middle

Last Name

MONIPPALLIL

Suffix

Business Name

SHANTHA K MONIPPALLIL MD

Original Issue Date

11/20/1978

Effective Date

08/20/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021