SHIVINDER S JOLLY Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035585

License Status

EXPIRED

Business

First Name

SHIVINDER

Middle

Last Name

JOLLY

Business Name

SHIVINDER S JOLLY

Original Issue Date

01/15/1997

Effective Date

01/15/1997

Expiration Date

06/30/2000

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

09/22/2006