SUPARNA MANTHA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036140720

License Status

ACTIVE

Business

Title

First Name

SUPARNA

Last Name

MANTHA

Business Name

SUPARNA MANTHA MD

Original Issue Date

05/19/2016

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

04/13/2023