BALAJI VENKAT DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052135

License Status

CANCELLED

Business

First Name

BALAJI

Last Name

VENKAT

Suffix

Business Name

BALAJI VENKAT DO

Original Issue Date

08/01/2009

Effective Date

08/01/2009

Expiration Date

07/31/2011

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Internal Medicine/Emergency Medicine

Ever Disciplined

LastModifiedDate

05/20/2009