KAVITHA BATHALA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040304

License Status

EXPIRED

Business

First Name

KAVITHA

Last Name

BATHALA

Business Name

KAVITHA BATHALA

Original Issue Date

06/24/1999

Effective Date

06/24/1999

Expiration Date

06/23/2002

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006