VENUGOPAL BOTLA - Medical Doctor License in Illinois | # 125038128

VENUGOPAL BOTLA

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038128

License Status

EXPIRED

Business

N

First Name

VENUGOPAL

Last Name

BOTLA

Business Name

VENUGOPAL BOTLA

Original Issue Date

06/01/1998

Effective Date

06/01/1998

Expiration Date

06/21/2001

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006