SIVASANKER BAKTHAVACHALAM MD - Medical Doctor License in Georgia | # 036119207

SIVASANKER BAKTHAVACHALAM MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119207

License Status

NOT RENEWED

Business

N

First Name

SIVASANKER

Last Name

BAKTHAVACHALAM

Suffix

MD

Business Name

SIVASANKER BAKTHAVACHALAM MD

Original Issue Date

08/16/2007

Effective Date

04/17/2008

Expiration Date

07/31/2011

State

GA

Ever Disciplined

N

LastModifiedDate

11/14/2011