KRISHNA MODI DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076406

License Status

CANCELLED

Business

Title

First Name

KRISHNA

Last Name

MODI

Business Name

KRISHNA MODI DO

Original Issue Date

06/29/2020

Effective Date

06/29/2020

Expiration Date

06/28/2023

City

CAROL STREAM

State

Zip

60188

County

DUPAGE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/04/2020