KIRANMAYI PENDYALA SURAPANENI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043128

License Status

EXPIRED

Business

First Name

KIRANMAYI

Middle

PENDYALA

Last Name

SURAPANENI

Suffix

Business Name

KIRANMAYI PENDYALA SURAPANENI MD

Original Issue Date

06/24/2001

Effective Date

06/24/2001

Expiration Date

06/23/2004

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006