SREENU PETER CHAKUMGAL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058970

License Status

CANCELLED

Business

Title

First Name

SREENU

Middle

PETER

Last Name

CHAKUMGAL

Business Name

SREENU PETER CHAKUMGAL MD

Original Issue Date

07/30/2010

Effective Date

07/30/2010

Expiration Date

07/29/2013

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/30/2010