MAMATHA BOLLINENI MD - Medical Doctor License in Illinois | # 125049836

MAMATHA BOLLINENI MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049836

License Status

CANCELLED

Business

N

First Name

MAMATHA

Last Name

BOLLINENI

Suffix

MD

Business Name

MAMATHA BOLLINENI MD

Original Issue Date

06/24/2005

Effective Date

06/24/2005

Expiration Date

06/23/2008

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006