GAUTAM KANTILAL BHANUSHALI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053936

License Status

EXPIRED

Business

Title

First Name

GAUTAM

Middle

KANTILAL

Last Name

BHANUSHALI

Business Name

GAUTAM KANTILAL BHANUSHALI 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