SUSHAMA MODY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043418

License Status

EXPIRED

Business

First Name

SUSHAMA

Last Name

MODY

Suffix

Business Name

SUSHAMA MODY MD

Original Issue Date

06/24/2001

Effective Date

06/24/2001

Expiration Date

06/23/2004

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006