KEERTI KANTILAL BHANUSHALI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057351

License Status

CANCELLED

Business

Title

First Name

KEERTI

Middle

KANTILAL

Last Name

BHANUSHALI

Business Name

KEERTI KANTILAL BHANUSHALI MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/15/2010