VINODA SHANTHAPPA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114697

License Status

ACTIVE

Business

Title

First Name

VINODA

Last Name

SHANTHAPPA

Business Name

VINODA SHANTHAPPA MD

Original Issue Date

10/04/2005

Effective Date

06/05/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

06/05/2023