CHAMPA R GOWDA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041755

License Status

EXPIRED

Business

First Name

CHAMPA

Middle

Last Name

GOWDA

Suffix

Business Name

CHAMPA R GOWDA MD

Original Issue Date

06/26/2000

Effective Date

06/26/2000

Expiration Date

06/25/2003

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006