KETAN G GOSWAMI MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109321

License Status

INACTIVE

Business

First Name

KETAN

Middle

Last Name

GOSWAMI

Suffix

Business Name

KETAN G GOSWAMI MD

Original Issue Date

05/23/2003

Effective Date

05/23/2003

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/09/2006