MANOGNYA MUTTINENI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144545

License Status

NOT RENEWED

Business

Title

First Name

MANOGNYA

Last Name

MUTTINENI

Business Name

MANOGNYA MUTTINENI MD

Original Issue Date

10/24/2017

Effective Date

10/24/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021