KANNAN MANICKAM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034695

License Status

EXPIRED

Business

First Name

KANNAN

Last Name

MANICKAM

Business Name

KANNAN MANICKAM

Original Issue Date

05/23/1996

Effective Date

05/23/1996

Expiration Date

07/28/1999

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

09/22/2006