BHAVANA THOTA KANDIKATTU MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036121510

License Status

ACTIVE

Business

First Name

BHAVANA

Middle

THOTA

Last Name

KANDIKATTU

Suffix

Business Name

BHAVANA THOTA KANDIKATTU MD

Original Issue Date

07/17/2008

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

04/08/2023