SRIRAM SAMBASIVAN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030577

License Status

EXPIRED

Business

First Name

SRIRAM

Last Name

SAMBASIVAN

Business Name

SRIRAM SAMBASIVAN

Original Issue Date

07/02/1993

Effective Date

07/02/1993

Expiration Date

06/28/1998

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006