DEEPTI MODY TOLIA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048533

License Status

EXPIRED

Business

First Name

DEEPTI

Middle

MODY

Last Name

TOLIA

Suffix

Business Name

DEEPTI MODY TOLIA DO

Original Issue Date

06/22/2004

Effective Date

06/22/2004

Expiration Date

06/21/2007

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/03/2007