KETKI C MODI Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032224

License Status

EXPIRED

Business

First Name

KETKI C

Last Name

MODI

Business Name

KETKI C MODI

Original Issue Date

07/18/1994

Effective Date

07/18/1994

Expiration Date

06/30/1997

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006