SUJATHA KONNANAT H PALAT Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036129

License Status

CANCELLED

Business

First Name

SUJATHA KONNANAT

Middle

Last Name

PALAT

Business Name

SUJATHA KONNANAT H PALAT

Original Issue Date

05/16/1997

Effective Date

05/16/1997

Expiration Date

06/30/2000

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006