KAVITA SRIRANGA PHATAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119383

License Status

NOT RENEWED

Business

First Name

KAVITA

Middle

SRIRANGA

Last Name

PHATAK

Suffix

Business Name

KAVITA SRIRANGA PHATAK MD

Original Issue Date

09/13/2007

Effective Date

09/13/2007

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008