PRANITHA VIJAYA PRODDUTURVAR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036123983

License Status

NOT RENEWED

Business

Title

First Name

PRANITHA

Middle

VIJAYA

Last Name

PRODDUTURVAR

Business Name

PRANITHA VIJAYA PRODDUTURVAR MD

Original Issue Date

07/13/2009

Effective Date

07/13/2009

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011