SIVASANKER BAKTHAVACHALAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119207

License Status

NOT RENEWED

Business

First Name

SIVASANKER

Last Name

BAKTHAVACHALAM

Suffix

Business Name

SIVASANKER BAKTHAVACHALAM MD

Original Issue Date

08/16/2007

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

ATLANTA

State

Zip

30338

County

GEORGIA

Ever Disciplined

LastModifiedDate

11/14/2011