KATYAYAN DWIVEDI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067713

License Status

EXPIRED

Business

Title

First Name

KATYAYAN

Last Name

DWIVEDI

Business Name

KATYAYAN DWIVEDI MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/25/2018