GANAPATHI R GOTTUMUKKALA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036074987

License Status

ACTIVE

Business

First Name

GANAPATHI R

Last Name

GOTTUMUKKALA

Business Name

GANAPATHI R GOTTUMUKKALA

Original Issue Date

05/11/1987

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/13/2023