KAVITA CHOWDARY GORANTLA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047779

License Status

EXPIRED

Business

First Name

KAVITA

Middle

CHOWDARY

Last Name

GORANTLA

Suffix

Business Name

KAVITA CHOWDARY GORANTLA MD

Original Issue Date

06/23/2004

Effective Date

06/23/2004

Expiration Date

06/22/2005

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006