KUNJAM HARISH MODHA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053925

License Status

EXPIRED

Business

Title

First Name

KUNJAM

Middle

HARISH

Last Name

MODHA

Business Name

KUNJAM HARISH MODHA MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/19/2011