AMTUL HAJIRA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059948

License Status

CANCELLED

Business

Title

First Name

AMTUL

Last Name

HAJIRA

Business Name

AMTUL HAJIRA DO

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/09/2011