SIVA S GUMMADI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125029102

License Status

EXPIRED

Business

First Name

SIVA

Middle

Last Name

GUMMADI

Suffix

Business Name

SIVA S GUMMADI MD

Original Issue Date

08/10/1992

Effective Date

08/10/1992

Expiration Date

08/06/1995

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006