SUBBIA GOUNDAR JAGANNATHAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046940

License Status

NOT RENEWED

Business

First Name

SUBBIA

Middle

GOUNDAR

Last Name

JAGANNATHAN

Suffix

Business Name

SUBBIA GOUNDAR JAGANNATHAN MD

Original Issue Date

02/07/1973

Effective Date

04/24/2017

Expiration Date

09/30/2020

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

01/14/2021