License holder summary

DAVID R KHASIDASHVILI is a Physician licensed to practice in Indiana. The address on file for DAVID R KHASIDASHVILI is FOREST HILLS NY 11375. This licensed professional license is not current. The license was granted 08/24/1984 and expired on 06/30/1986.

Indiana

Professional Licensing Agency

DAVID R KHASIDASHVILI
Physician
License number
01033662A
Date granted
08/24/1984
Date expires
06/30/1986
Class
Physician
Status
Expired Non-Renewable
Address
FOREST HILLS NY 11375
indianalicensing.org
ID 6052352
LAST UPDATED 2026-03-22 15:51:32 UTC

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