GOUTHAM KONDAPI DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036160201

License Status

ACTIVE

Business

Title

First Name

GOUTHAM

Last Name

KONDAPI

Business Name

GOUTHAM KONDAPI DO

Original Issue Date

04/12/2022

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

EVERGREEN PARK

State

Zip

60805

County

COOK

Ever Disciplined

LastModifiedDate

06/09/2023