PRAKASH SIDHA JAYABALAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066284

License Status

CANCELLED

Business

Title

First Name

PRAKASH

Middle

SIDHA

Last Name

JAYABALAN

Business Name

PRAKASH SIDHA JAYABALAN MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2016

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Sports Medicine (PM&R)

Ever Disciplined

LastModifiedDate

05/04/2015