LATA IYER PATEL DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048293

License Status

EXPIRED

Business

First Name

LATA

Middle

IYER

Last Name

PATEL

Suffix

Business Name

LATA IYER PATEL DO

Original Issue Date

06/09/2004

Effective Date

06/09/2004

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/03/2007