ANEESH VENKAT PAKALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036147423

License Status

NOT RENEWED

Business

Title

First Name

ANEESH

Middle

VENKAT

Last Name

PAKALA

Business Name

ANEESH VENKAT PAKALA MD

Original Issue Date

09/13/2018

Effective Date

09/13/2018

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021