SAMDEEP KONDA MOULI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059066

License Status

CANCELLED

Business

Title

First Name

SAMDEEP

Middle

KONDA

Last Name

MOULI

Business Name

SAMDEEP KONDA MOULI MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/24/2014