SHRUTI MITTAL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062391

License Status

CANCELLED

Business

Title

First Name

SHRUTI

Last Name

MITTAL

Business Name

SHRUTI MITTAL MD

Original Issue Date

07/05/2012

Effective Date

07/05/2012

Expiration Date

07/04/2015

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

03/24/2014