PHANICHARAN ADITYA SISTLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001048

License Status

NOT RENEWED

Business

Title

First Name

PHANICHARAN

Middle

ADITYA

Last Name

SISTLA

Business Name

PHANICHARAN ADITYA SISTLA MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

07/31/2015

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Nephrology

Ever Disciplined

LastModifiedDate

01/07/2016