OM PRAKASH JHA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055564

License Status

CANCELLED

Business

Title

First Name

Middle

PRAKASH

Last Name

JHA

Business Name

OM PRAKASH JHA MD

Original Issue Date

08/15/2011

Effective Date

08/15/2011

Expiration Date

08/14/2012

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

08/03/2011