NIKHILESH PENMETSA RAJU MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074459

License Status

CANCELLED

Business

Title

First Name

NIKHILESH

Middle

PENMETSA

Last Name

RAJU

Business Name

NIKHILESH PENMETSA RAJU MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

06/24/2021