KUNJAM HARISH MODHA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129546

License Status

NOT RENEWED

Business

Title

First Name

KUNJAM

Middle

HARISH

Last Name

MODHA

Business Name

KUNJAM HARISH MODHA MD

Original Issue Date

02/01/2012

Effective Date

02/01/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014