ANANDA SOM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033503

License Status

EXPIRED

Business

First Name

ANANDA

Last Name

SOM

Suffix

Business Name

ANANDA SOM MD

Original Issue Date

06/21/1995

Effective Date

06/21/1995

Expiration Date

06/30/1998

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006