DIMPLE H MODI Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052887

License Status

EXPIRED

Business

First Name

DIMPLE

Middle

Last Name

MODI

Business Name

DIMPLE H MODI

Original Issue Date

06/23/2007

Effective Date

06/23/2007

Expiration Date

06/22/2008

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Transitional Year

Ever Disciplined

LastModifiedDate

06/26/2008