PREMAL MADHUKAR TRIVEDI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053507

License Status

CANCELLED

Business

Title

First Name

PREMAL

Middle

MADHUKAR

Last Name

TRIVEDI

Business Name

PREMAL MADHUKAR TRIVEDI MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

06/07/2007