AMOD OM SUREKA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040900

License Status

EXPIRED

Business

First Name

AMOD

Middle

Last Name

SUREKA

Suffix

Business Name

AMOD OM SUREKA MD

Original Issue Date

06/28/2000

Effective Date

06/28/2000

Expiration Date

06/27/2003

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006