BALAKRISHNA SHIVASHANKER BANGALORE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048726

License Status

EXPIRED

Business

First Name

BALAKRISHNA

Middle

SHIVASHANKER

Last Name

BANGALORE

Suffix

Business Name

BALAKRISHNA SHIVASHANKER BANGALORE MD

Original Issue Date

07/13/2004

Effective Date

07/13/2004

Expiration Date

07/12/2007

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

07/25/2007