EZHILI A MANISUNDARAM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037111

License Status

EXPIRED

Business

First Name

EZHILI

Middle

Last Name

MANISUNDARAM

Business Name

EZHILI A MANISUNDARAM

Original Issue Date

07/14/1997

Effective Date

07/14/1997

Expiration Date

06/30/2000

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006