PRASANTH MANTHENA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039133

License Status

EXPIRED

Business

First Name

PRASANTH

Last Name

MANTHENA

Business Name

PRASANTH MANTHENA

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2003

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

09/22/2006