SUSHAMA MODY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036110826

License Status

NOT RENEWED

Business

First Name

SUSHAMA

Last Name

MODY

Suffix

Business Name

SUSHAMA MODY MD

Original Issue Date

02/17/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

06/03/2009