PRAVEEN KANDULA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113938

License Status

NOT RENEWED

Business

First Name

PRAVEEN

Last Name

KANDULA

Suffix

Business Name

PRAVEEN KANDULA MD

Original Issue Date

06/20/2005

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/14/2011