MATHEW J KALLOOKULANGARA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043515

License Status

EXPIRED

Business

First Name

MATHEW

Middle

Last Name

KALLOOKULANGARA

Business Name

MATHEW J KALLOOKULANGARA

Original Issue Date

06/26/2001

Effective Date

06/26/2001

Expiration Date

06/25/2004

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006