MITRA B BOODRAM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024011

License Status

EXPIRED

Business

First Name

MITRA B

Last Name

BOODRAM

Suffix

Business Name

MITRA B BOODRAM MD

Original Issue Date

06/01/1989

Effective Date

06/01/1989

Expiration Date

06/21/1994

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006