KALYAN CHAKRAVARTHY POTU MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036148458

License Status

ACTIVE

Business

Title

First Name

KALYAN

Middle

CHAKRAVARTHY

Last Name

POTU

Business Name

KALYAN CHAKRAVARTHY POTU MD

Original Issue Date

03/06/2019

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/06/2023