VIDYA JAGANATH PUTHENVEETIL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108105

License Status

ACTIVE

Business

First Name

VIDYA

Middle

JAGANATH

Last Name

PUTHENVEETIL

Suffix

Business Name

VIDYA JAGANATH PUTHENVEETIL MD

Original Issue Date

10/31/2002

Effective Date

04/20/2023

Expiration Date

07/31/2026

City

LAKE FOREST

State

Zip

60045

County

LAKE

Ever Disciplined

LastModifiedDate

04/20/2023