MANISH MADHUKAR SHUKLA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036835

License Status

EXPIRED

Business

First Name

MANISH

Middle

MADHUKAR

Last Name

SHUKLA

Suffix

Business Name

MANISH MADHUKAR SHUKLA MD

Original Issue Date

06/18/1997

Effective Date

06/18/1997

Expiration Date

06/30/1999

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006