KALYAN GHANTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045790

License Status

EXPIRED

Business

First Name

KALYAN

Last Name

GHANTA

Suffix

Business Name

KALYAN GHANTA MD

Original Issue Date

06/24/2003

Effective Date

06/24/2003

Expiration Date

06/23/2006

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006