PRASANTA L BHAMIDIPATI Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036126754

License Status

ACTIVE

Business

First Name

PRASANTA

Middle

Last Name

BHAMIDIPATI

Business Name

PRASANTA L BHAMIDIPATI

Original Issue Date

10/08/2010

Effective Date

07/25/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/25/2023