PHANIVARDHAN R BABIREDDY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129719

License Status

ACTIVE

Business

Title

First Name

PHANIVARDHAN

Middle

Last Name

BABIREDDY

Business Name

PHANIVARDHAN R BABIREDDY MD

Original Issue Date

03/06/2012

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

07/27/2023