SUPAL MEHTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078818

License Status

EXPIRED

Business

Title

First Name

SUPAL

Last Name

MEHTA

Business Name

SUPAL MEHTA MD

Original Issue Date

06/25/2021

Effective Date

06/25/2021

Expiration Date

06/24/2024

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/30/2024