VENKAT RAGHAVAN TIRUMALA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047618

License Status

CANCELLED

Business

First Name

VENKAT

Middle

RAGHAVAN

Last Name

TIRUMALA

Suffix

Business Name

VENKAT RAGHAVAN TIRUMALA MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006