JAYDIP DATTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031003

License Status

EXPIRED

Business

First Name

JAYDIP

Last Name

DATTA

Suffix

Business Name

JAYDIP DATTA MD

Original Issue Date

05/09/1994

Effective Date

05/09/1994

Expiration Date

06/25/1997

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006