PRIYANTHIE GANENTHIRAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064457

License Status

EXPIRED

Business

Title

First Name

PRIYANTHIE

Last Name

GANENTHIRAN

Business Name

PRIYANTHIE GANENTHIRAN MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2017

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/19/2017