VENUGOPAL BOTLA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038128

License Status

EXPIRED

Business

First Name

VENUGOPAL

Last Name

BOTLA

Business Name

VENUGOPAL BOTLA

Original Issue Date

06/01/1998

Effective Date

06/01/1998

Expiration Date

06/21/2001

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006