PUSHPA K MAMTANI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036064091

License Status

ACTIVE

Business

First Name

PUSHPA

Middle

Last Name

MAMTANI

Suffix

Business Name

PUSHPA K MAMTANI MD

Original Issue Date

03/22/1982

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

SYCAMORE

State

Zip

60178

County

LA SALLE

Ever Disciplined

LastModifiedDate

11/02/2023