BONEY MATTATHETHU NINAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057406

License Status

CANCELLED

Business

Title

First Name

BONEY

Middle

MATTATHETHU

Last Name

NINAN

Business Name

BONEY MATTATHETHU NINAN 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

04/22/2010