ANDREW PAUL THALIATH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036163093

License Status

ACTIVE

Business

Title

First Name

ANDREW

Middle

PAUL

Last Name

THALIATH

Business Name

ANDREW PAUL THALIATH MD

Original Issue Date

12/05/2022

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/08/2023