SHAMIK BHARAT TRIVEDI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056898

License Status

CANCELLED

Business

First Name

SHAMIK

Middle

BHARAT

Last Name

TRIVEDI

Suffix

Business Name

SHAMIK BHARAT TRIVEDI MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/13/2009