JAYASANKARI PONNUSAMY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048839

License Status

CANCELLED

Business

First Name

JAYASANKARI

Last Name

PONNUSAMY

Suffix

Business Name

JAYASANKARI PONNUSAMY MD

Original Issue Date

11/23/2004

Effective Date

11/23/2004

Expiration Date

11/22/2007

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006