CHARITH NILRAN FONSEKA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000491

License Status

EXPIRED

Business

First Name

CHARITH

Middle

NILRAN

Last Name

FONSEKA

Suffix

Business Name

CHARITH NILRAN FONSEKA MD

Original Issue Date

11/01/2012

Effective Date

11/01/2012

Expiration Date

04/30/2013

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

07/03/2013