SURYA P MENTA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036100090

License Status

ACTIVE

Business

First Name

SURYA

Middle

Last Name

MENTA

Suffix

Business Name

SURYA P MENTA MD

Original Issue Date

04/27/1999

Effective Date

05/11/2023

Expiration Date

07/31/2026

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/11/2023