BERTRAM H NANAYAKKARA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036067957

License Status

NOT RENEWED

Business

First Name

BERTRAM H

Last Name

NANAYAKKARA

Suffix

Business Name

BERTRAM H NANAYAKKARA MD

Original Issue Date

11/16/1983

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/14/2021