SHEENA A EETTICKAL DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068186

License Status

CANCELLED

Business

Title

First Name

SHEENA

Middle

Last Name

EETTICKAL

Business Name

SHEENA A EETTICKAL DO

Original Issue Date

06/27/2016

Effective Date

06/27/2016

Expiration Date

06/26/2019

City

ELMHURST

State

Zip

60126

County

DUPAGE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/29/2016