RAVILLA LAKSHMIPATHY MAHIDHAR MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048484

License Status

EXPIRED

Business

First Name

RAVILLA

Middle

LAKSHMIPATHY

Last Name

MAHIDHAR

Suffix

Business Name

RAVILLA LAKSHMIPATHY MAHIDHAR MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/03/2007