ISHANI SUJATHA ALI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111079

License Status

NOT RENEWED

Business

First Name

ISHANI

Middle

SUJATHA

Last Name

ALI

Suffix

Business Name

ISHANI SUJATHA ALI MD

Original Issue Date

03/24/2004

Effective Date

08/03/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

11/30/2023