MADAHARI T HENRY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078188

License Status

EXPIRED

Business

Title

First Name

MADAHARI

Middle

Last Name

HENRY

Business Name

MADAHARI T HENRY MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/30/2024