AMMU THAMPI SUSHEELA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075296

License Status

CANCELLED

Business

Title

First Name

AMMU

Middle

THAMPI

Last Name

SUSHEELA

Business Name

AMMU THAMPI SUSHEELA MD

Original Issue Date

07/15/2022

Effective Date

07/15/2022

Expiration Date

07/14/2023

City

BERWYN

State

Zip

60402

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/27/2022