PREM KUMAR KONAKONDLA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043317

License Status

EXPIRED

Business

First Name

PREM

Middle

KUMAR

Last Name

KONAKONDLA

Business Name

PREM KUMAR KONAKONDLA

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2004

City

PEORIA

State

Zip

61602

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006