SAJU S EAPEN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032973

License Status

EXPIRED

Business

First Name

SAJU S

Last Name

EAPEN

Business Name

SAJU S EAPEN

Original Issue Date

06/03/1995

Effective Date

06/03/1995

Expiration Date

06/30/1998

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006