SHYAM KIRAN GANDAM-VENKATA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036143316

License Status

ACTIVE

Business

Title

First Name

SHYAM KIRAN

Last Name

GANDAM-VENKATA

Business Name

SHYAM KIRAN GANDAM-VENKATA MD

Original Issue Date

05/31/2017

Effective Date

05/29/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/29/2023