JAINI VIREN MODY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058454

License Status

CANCELLED

Business

Title

First Name

JAINI

Middle

VIREN

Last Name

MODY

Business Name

JAINI VIREN MODY MD

Original Issue Date

06/21/2010

Effective Date

06/21/2010

Expiration Date

06/20/2012

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/03/2010