DEEPTHI BUSAYAVALASA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068035

License Status

EXPIRED

Business

Title

First Name

DEEPTHI

Last Name

BUSAYAVALASA

Business Name

DEEPTHI BUSAYAVALASA MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2019

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/02/2019