KSHITIJ AMBRISH DALAL Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045360

License Status

CANCELLED

Business

First Name

KSHITIJ

Middle

AMBRISH

Last Name

DALAL

Business Name

KSHITIJ AMBRISH DALAL

Original Issue Date

06/24/2002

Effective Date

06/24/2002

Expiration Date

06/23/2005

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006