GAUTHAM PRAKASH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076077

License Status

EXPIRED

Business

First Name

GAUTHAM

Last Name

PRAKASH

Business Name

GAUTHAM PRAKASH

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2023

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/06/2024