SASHIDHAR VENKATA GANTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036106152

License Status

NOT RENEWED

Business

First Name

SASHIDHAR

Middle

VENKATA

Last Name

GANTA

Suffix

Business Name

SASHIDHAR VENKATA GANTA MD

Original Issue Date

01/24/2002

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Ever Disciplined

LastModifiedDate

11/06/2008