DIWAKAR T PULISETTY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114660

License Status

NOT RENEWED

Business

First Name

DIWAKAR

Middle

Last Name

PULISETTY

Suffix

Business Name

DIWAKAR T PULISETTY MD

Original Issue Date

09/26/2005

Effective Date

06/25/2008

Expiration Date

07/31/2011

City

EAST SAINT LOUIS

State

Zip

62201

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

11/14/2011