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DHMH : cdssearch: M16568

CDSPERMIT

M16568

APPLICANT_NAME

A CATHERINE N PURUSHOTHAMAN

APPLICANT_STATUS

LICENSED

CLASSIFICATION

PRACTITIONER

ADRESS

WASHINGTON ADV HOSP

CITY

TAKOMA PARK

COUNTY

 

ZIP

20912

STATE

MD

ADDRESS2

7600 CARROLL AVE

PROFESSION

MD

LICENSE_ISSUEDDATE

9/1/2013 12:00 AM

LICENSE_EXPDATE

8/31/2015 12:00 AM

CURR_CERTIFICATION

Y

Attachments

Created at 11/21/2013 11:55 AM by System Account
Last modified at 11/21/2013 11:55 AM by System Account