RAJA RAMESH GUMMALLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

Title

First Name

RAJA

Middle

RAMESH

Last Name

GUMMALLA

Business Name

RAJA RAMESH GUMMALLA MD

Original Issue Date

04/09/2013

Effective Date

04/09/2013

Expiration Date

07/31/2014

City

JACKSONVILLE

State

Zip

32256

County

FLORIDA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014