DEEPA U MENON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036094434

License Status

NOT RENEWED

Business

First Name

DEEPA

Middle

Last Name

MENON

Suffix

Business Name

DEEPA U MENON MD

Original Issue Date

10/23/1996

Effective Date

10/23/1996

Expiration Date

07/31/2002

City

BETHALTO

State

Zip

62010

County

MADISON

Ever Disciplined

LastModifiedDate

10/09/2006