SHYAM MOHAN PUPPALA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125018956

License Status

EXPIRED

Business

First Name

SHYAM MOHAN

Last Name

PUPPALA

Suffix

Business Name

SHYAM MOHAN PUPPALA MD

Original Issue Date

08/09/1985

Effective Date

08/09/1985

Expiration Date

07/01/1988

City

OAK FOREST

State

Zip

60452

County

COOK

Specialty/Qualifier

Geriatric Medicine

Ever Disciplined

LastModifiedDate

09/22/2006