TRACY J BANSIDHAR Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036756

License Status

EXPIRED

Business

First Name

TRACY

Middle

Last Name

BANSIDHAR

Business Name

TRACY J BANSIDHAR

Original Issue Date

06/16/1997

Effective Date

06/16/1997

Expiration Date

06/30/2000

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006