SRINIVAS M MASCAL GANGADHARAIAH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055614

License Status

EXPIRED

Business

First Name

SRINIVAS

Middle

Last Name

MASCAL GANGADHARAIAH

Business Name

SRINIVAS M MASCAL GANGADHARAIAH

Original Issue Date

06/16/2009

Effective Date

06/16/2009

Expiration Date

06/15/2012

City

MELROSE PARK

State

Zip

60160

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

08/29/2012