DIVYA MUTYALA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050621

License Status

EXPIRED

Business

First Name

DIVYA

Last Name

MUTYALA

Suffix

Business Name

DIVYA MUTYALA MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

07/15/2009