SIDDHARTHA GANGULY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125029328

License Status

EXPIRED

Business

First Name

SIDDHARTHA

Last Name

GANGULY

Suffix

Business Name

SIDDHARTHA GANGULY MD

Original Issue Date

05/04/1993

Effective Date

05/04/1993

Expiration Date

06/25/1996

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006