CHAMPA R GOWDA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108969

License Status

NOT RENEWED

Business

First Name

CHAMPA

Middle

Last Name

GOWDA

Suffix

Business Name

CHAMPA R GOWDA MD

Original Issue Date

04/08/2003

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

PEORIA

State

Zip

61636

County

PEORIA

Ever Disciplined

LastModifiedDate

11/14/2011