ALEXANDER P MATHAI Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045016

License Status

EXPIRED

Business

First Name

ALEXANDER

Middle

Last Name

MATHAI

Business Name

ALEXANDER P MATHAI

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006