SHOMA RAGHAVAN IYENGAR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041760

License Status

CANCELLED

Business

First Name

SHOMA

Middle

RAGHAVAN

Last Name

IYENGAR

Suffix

Business Name

SHOMA RAGHAVAN IYENGAR MD

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

06/30/2003

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006