IRA N SHUKLA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064917

License Status

EXPIRED

Business

Title

First Name

IRA

Middle

Last Name

SHUKLA

Business Name

IRA N SHUKLA MD

Original Issue Date

06/26/2014

Effective Date

06/26/2014

Expiration Date

06/25/2017

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/19/2017