SHANTI LAL BANSAL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047345

License Status

EXPIRED

Business

First Name

SHANTI

Middle

LAL

Last Name

BANSAL

Suffix

Business Name

SHANTI LAL BANSAL MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/03/2007