PRIYANKA SURESH SHASTRI DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071786

License Status

CANCELLED

Business

Title

First Name

PRIYANKA

Middle

SURESH

Last Name

SHASTRI

Business Name

PRIYANKA SURESH SHASTRI DO

Original Issue Date

06/24/2018

Effective Date

06/24/2018

Expiration Date

06/23/2021

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/01/2018