MEDHAT W TAKLA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000349

License Status

EXPIRED

Business

First Name

MEDHAT W

Last Name

TAKLA

Suffix

Business Name

MEDHAT W TAKLA MD

Original Issue Date

09/17/2008

Effective Date

09/17/2008

Expiration Date

03/16/2009

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Ever Disciplined

LastModifiedDate

03/18/2009