PRATIMA CHALASANI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057154

License Status

CANCELLED

Business

Title

First Name

PRATIMA

Last Name

CHALASANI

Business Name

PRATIMA CHALASANI MD

Original Issue Date

06/26/2009

Effective Date

06/26/2009

Expiration Date

06/25/2012

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/07/2009