SURSIT S MANIKTALA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024368

License Status

EXPIRED

Business

First Name

SURSIT

Middle

Last Name

MANIKTALA

Business Name

SURSIT S MANIKTALA

Original Issue Date

07/03/1989

Effective Date

07/03/1989

Expiration Date

06/30/1992

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006