ANITA MEHTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052744

License Status

EXPIRED

Business

First Name

ANITA

Last Name

MEHTA

Suffix

Business Name

ANITA MEHTA MD

Original Issue Date

06/26/2010

Effective Date

06/26/2010

Expiration Date

06/25/2011

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

07/19/2011