SHREEVIDYA VATTAPARAMBIL MENON DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055432

License Status

CANCELLED

Business

Title

First Name

SHREEVIDYA

Middle

VATTAPARAMBIL

Last Name

MENON

Business Name

SHREEVIDYA VATTAPARAMBIL MENON DO

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

Pediatrics

Ever Disciplined

LastModifiedDate

06/03/2008