MYDHILI NANDANAN MOORTHIE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056984

License Status

CANCELLED

Business

Title

First Name

MYDHILI

Middle

NANDANAN

Last Name

MOORTHIE

Business Name

MYDHILI NANDANAN MOORTHIE MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

SOUTH ELGIN

State

Zip

60177

County

KANE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/12/2009