BONEY MATTATHETHU NINAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036132199

License Status

NOT RENEWED

Business

Title

First Name

BONEY

Middle

MATTATHETHU

Last Name

NINAN

Business Name

BONEY MATTATHETHU NINAN MD

Original Issue Date

04/02/2013

Effective Date

04/14/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017