TEDDI ISHAK BACHAWATY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113129

License Status

NOT RENEWED

Business

First Name

TEDDI

Middle

ISHAK

Last Name

BACHAWATY

Suffix

Business Name

TEDDI ISHAK BACHAWATY MD

Original Issue Date

02/22/2005

Effective Date

07/10/2014

Expiration Date

07/31/2017

City

WEST SPRINGFIELD

State

Zip

01089

County

MASSACHUSETTS

Ever Disciplined

LastModifiedDate

11/01/2017