AMITA A BAGAL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034961

License Status

EXPIRED

Business

First Name

AMITA

Middle

Last Name

BAGAL

Business Name

AMITA A BAGAL

Original Issue Date

06/12/1996

Effective Date

06/12/1996

Expiration Date

06/23/2001

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

09/22/2006