KAVITA PENDURTHI Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027513

License Status

EXPIRED

Business

First Name

KAVITA

Last Name

PENDURTHI

Business Name

KAVITA PENDURTHI

Original Issue Date

08/16/1991

Effective Date

08/16/1991

Expiration Date

09/16/1994

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006