DEEPICA REDDY GANTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044083

License Status

EXPIRED

Business

First Name

DEEPICA

Middle

REDDY

Last Name

GANTA

Suffix

Business Name

DEEPICA REDDY GANTA MD

Original Issue Date

06/24/2002

Effective Date

06/24/2002

Expiration Date

06/23/2006

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006