BENJAMIN MATTACKAL NINAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000113

License Status

EXPIRED

Business

First Name

BENJAMIN

Middle

MATTACKAL

Last Name

NINAN

Suffix

Business Name

BENJAMIN MATTACKAL NINAN MD

Original Issue Date

10/20/2000

Effective Date

10/20/2000

Expiration Date

04/19/2001

City

OAK LAWN

State

Zip

60453

County

COOK

Ever Disciplined

LastModifiedDate

09/23/2006