SIDHARTA PENA GANGADHARAN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000412

License Status

EXPIRED

Business

First Name

SIDHARTA

Middle

PENA

Last Name

GANGADHARAN

Business Name

SIDHARTA PENA GANGADHARAN

Original Issue Date

09/01/2010

Effective Date

09/01/2010

Expiration Date

02/28/2011

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Thoracic Surgery

Ever Disciplined

LastModifiedDate

03/24/2011