VENKAT R MANTHA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125029121

License Status

EXPIRED

Business

First Name

VENKAT

Middle

Last Name

MANTHA

Suffix

Business Name

VENKAT R MANTHA MD

Original Issue Date

08/17/1992

Effective Date

08/17/1992

Expiration Date

08/13/1993

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006