MRIDULA BANAJI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034972

License Status

EXPIRED

Business

First Name

MRIDULA

Last Name

BANAJI

Suffix

Business Name

MRIDULA BANAJI MD

Original Issue Date

06/12/1996

Effective Date

06/12/1996

Expiration Date

06/30/1999

City

ROCKFORD

State

Zip

61107

County

BOONE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006