DEEPAK A SHIVRAM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031891

License Status

EXPIRED

Business

First Name

DEEPAK

Middle

Last Name

SHIVRAM

Business Name

DEEPAK A SHIVRAM

Original Issue Date

06/20/1994

Effective Date

06/20/1994

Expiration Date

06/30/1997

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006