ANASUYA S BRAHMAMDAM Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056501

License Status

CANCELLED

Business

First Name

ANASUYA

Middle

Last Name

BRAHMAMDAM

Business Name

ANASUYA S BRAHMAMDAM

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/14/2009