BANU PRASAD MYNENI DO - Medical Doctor License in Pennsylvania | # 036144866

BANU PRASAD MYNENI DO

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144866

License Status

NOT RENEWED

Business

N

Title

DO

First Name

BANU

Middle

PRASAD

Last Name

MYNENI

Business Name

BANU PRASAD MYNENI DO

Original Issue Date

12/29/2017

Effective Date

12/29/2017

Expiration Date

09/30/2020

State

PA

Ever Disciplined

N

LastModifiedDate

01/14/2021