JISHANTH MATTUMPURAM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068394

License Status

CANCELLED

Business

Title

First Name

JISHANTH

Last Name

MATTUMPURAM

Business Name

JISHANTH MATTUMPURAM MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/12/2016