PRAKASH GATTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045074

License Status

EXPIRED

Business

First Name

PRAKASH

Last Name

GATTA

Suffix

Business Name

PRAKASH GATTA MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2006

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006