LAVANYA BODDU MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050114

License Status

EXPIRED

Business

First Name

LAVANYA

Last Name

BODDU

Suffix

Business Name

LAVANYA BODDU MD

Original Issue Date

06/24/2005

Effective Date

06/24/2005

Expiration Date

06/23/2008

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/26/2008