ALI BALTAJI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074501

License Status

EXPIRED

Business

Title

First Name

ALI

Last Name

BALTAJI

Business Name

ALI BALTAJI MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2022

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/11/2022