RACHANA SURA FOFARIA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047490

License Status

CANCELLED

Business

First Name

RACHANA

Middle

SURA

Last Name

FOFARIA

Suffix

Business Name

RACHANA SURA FOFARIA MD

Original Issue Date

06/24/2004

Effective Date

06/24/2004

Expiration Date

06/23/2007

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006