VENUGOPAL BOTLA Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105602

License Status

INACTIVE

Business

First Name

VENUGOPAL

Last Name

BOTLA

Business Name

VENUGOPAL BOTLA

Original Issue Date

09/18/2001

Effective Date

09/18/2001

Expiration Date

07/31/2002

City

NORTHBROOK

State

Zip

60062

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006