SHANTALA S SREERAMA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033961

License Status

EXPIRED

Business

First Name

SHANTALA

Middle

Last Name

SREERAMA

Business Name

SHANTALA S SREERAMA

Original Issue Date

10/07/1995

Effective Date

10/07/1995

Expiration Date

10/04/1998

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006