SHANTA DEVI MATTAI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113175

License Status

ACTIVE

Business

First Name

SHANTA

Middle

DEVI

Last Name

MATTAI

Suffix

Business Name

SHANTA DEVI MATTAI MD

Original Issue Date

03/01/2005

Effective Date

04/25/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

04/25/2023