PREETI SUBRAMANYA SHASTRI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051593

License Status

EXPIRED

Business

First Name

PREETI

Middle

SUBRAMANYA

Last Name

SHASTRI

Suffix

Business Name

PREETI SUBRAMANYA SHASTRI MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2011

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

Sports Medicine (Family Practice)

Ever Disciplined

LastModifiedDate

07/19/2011