SUSHMA NAGABHAIRAVA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059200

License Status

CANCELLED

Business

Title

First Name

SUSHMA

Last Name

NAGABHAIRAVA

Business Name

SUSHMA NAGABHAIRAVA MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

01/27/2014