PRANITHA VIJAYA PRODDUTURVAR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052637

License Status

CANCELLED

Business

Title

First Name

PRANITHA

Middle

VIJAYA

Last Name

PRODDUTURVAR

Business Name

PRANITHA VIJAYA PRODDUTURVAR MD

Original Issue Date

06/20/2007

Effective Date

06/20/2007

Expiration Date

06/19/2010

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/14/2007