ANJALI S GODAMBE DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052617

License Status

CANCELLED

Business

First Name

ANJALI

Middle

Last Name

GODAMBE

Suffix

Business Name

ANJALI S GODAMBE DO

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2011

City

INDIANAPOLIS

State

Zip

46219

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

03/24/2010