SUSMITHA P KOLLI Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030001

License Status

EXPIRED

Business

First Name

SUSMITHA

Middle

Last Name

KOLLI

Business Name

SUSMITHA P KOLLI

Original Issue Date

05/28/1993

Effective Date

05/28/1993

Expiration Date

06/20/1994

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006