GORANTLA GOVINDAIAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036049003

License Status

NOT RENEWED

Business

First Name

GORANTLA

Last Name

GOVINDAIAH

Suffix

Business Name

GORANTLA GOVINDAIAH MD

Original Issue Date

03/11/1974

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

01/14/2021