LAVISHA PRAKASH MIRPURI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125083862

License Status

ACTIVE

Business

Title

First Name

LAVISHA

Middle

PRAKASH

Last Name

MIRPURI

Business Name

LAVISHA PRAKASH MIRPURI MD

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

06/30/2027

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/22/2024