SASIKANTH GORANTLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036138858

License Status

ACTIVE

Business

Title

First Name

SASIKANTH

Last Name

GORANTLA

Business Name

SASIKANTH GORANTLA MD

Original Issue Date

08/05/2015

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

EDWARDS

State

Zip

61528

County

PEORIA

Ever Disciplined

LastModifiedDate

04/12/2023