DIVYA S MALLADI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036125037

License Status

NOT RENEWED

Business

First Name

DIVYA

Middle

Last Name

MALLADI

Suffix

Business Name

DIVYA S MALLADI MD

Original Issue Date

02/24/2010

Effective Date

08/30/2017

Expiration Date

09/30/2020

City

GILBERT

State

Zip

85297

County

ARIZONA

Ever Disciplined

LastModifiedDate

01/14/2021