RUPASHREE R MANDALA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078948

License Status

CANCELLED

Business

Title

First Name

RUPASHREE

Middle

Last Name

MANDALA

Business Name

RUPASHREE R MANDALA DO

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

Pediatrics

Ever Disciplined

LastModifiedDate

06/15/2021