SHAKTI KUMAR MATTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032604

License Status

EXPIRED

Business

First Name

SHAKTI KUMAR

Last Name

MATTA

Suffix

Business Name

SHAKTI KUMAR MATTA MD

Original Issue Date

05/23/1995

Effective Date

05/23/1995

Expiration Date

06/30/1998

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006