BHAVANA THOTA KANDIKATTU MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050396

License Status

EXPIRED

Business

First Name

BHAVANA

Middle

THOTA

Last Name

KANDIKATTU

Suffix

Business Name

BHAVANA THOTA KANDIKATTU MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

08/20/2008

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/05/2008