KALYAN GHANTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

KALYAN

Last Name

GHANTA

Suffix

Business Name

KALYAN GHANTA MD

Original Issue Date

12/13/2005

Effective Date

12/13/2005

Expiration Date

07/31/2008

City

EVANSTON

State

Zip

60202

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008