PRAKASH J PEDAPATI MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058366

License Status

INACTIVE

Business

First Name

PRAKASH J

Last Name

PEDAPATI

Suffix

Business Name

PRAKASH J PEDAPATI MD

Original Issue Date

02/21/1979

Effective Date

08/31/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

04/04/2023