MANJU T POOVATHOOR Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041582

License Status

CANCELLED

Business

First Name

MANJU T

Last Name

POOVATHOOR

Business Name

MANJU T POOVATHOOR

Original Issue Date

06/21/2000

Effective Date

06/21/2000

Expiration Date

06/20/2003

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006