VENKAT R MANTHA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036088404

License Status

NOT RENEWED

Business

First Name

VENKAT

Middle

Last Name

MANTHA

Suffix

Business Name

VENKAT R MANTHA MD

Original Issue Date

05/10/1994

Effective Date

05/10/1994

Expiration Date

07/31/2005

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Ever Disciplined

LastModifiedDate

07/14/2014