NITHIN CHARLLY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125079374

License Status

CANCELLED

Business

Title

First Name

NITHIN

Last Name

CHARLLY

Business Name

NITHIN CHARLLY MD

Original Issue Date

06/23/2022

Effective Date

06/23/2022

Expiration Date

06/22/2025

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/20/2024