SUNIL KUMAR THAGHALLI SIDDEGOWDA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057286

License Status

EXPIRED

Business

Title

First Name

SUNIL

Middle

KUMAR

Last Name

THAGHALLI SIDDEGOWDA

Business Name

SUNIL KUMAR THAGHALLI SIDDEGOWDA MD

Original Issue Date

06/15/2010

Effective Date

06/15/2010

Expiration Date

06/14/2013

City

MELROSE PARK

State

Zip

60160

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/03/2013