KAVITA SRIRANGA PHATAK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048921

License Status

EXPIRED

Business

First Name

KAVITA

Middle

SRIRANGA

Last Name

PHATAK

Suffix

Business Name

KAVITA SRIRANGA PHATAK MD

Original Issue Date

06/20/2005

Effective Date

06/20/2005

Expiration Date

06/19/2008

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/26/2008