SHWETHA MALLESARA SUDHAKAR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129864

License Status

NOT RENEWED

Business

Title

First Name

SHWETHA

Last Name

MALLESARA SUDHAKAR

Business Name

SHWETHA MALLESARA SUDHAKAR MD

Original Issue Date

03/28/2012

Effective Date

03/28/2012

Expiration Date

07/31/2014

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

11/17/2014