HARSHA VARDHANA MOOLE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036141251

License Status

NOT RENEWED

Business

Title

First Name

HARSHA

Middle

VARDHANA

Last Name

MOOLE

Business Name

HARSHA VARDHANA MOOLE MD

Original Issue Date

07/18/2016

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

LINCOLN

State

Zip

62656

County

PEORIA

Ever Disciplined

LastModifiedDate

01/14/2021