LAKSHMI DATLA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052423

License Status

EXPIRED

Business

Title

First Name

LAKSHMI

Last Name

DATLA

Business Name

LAKSHMI DATLA MD

Original Issue Date

06/16/2010

Effective Date

06/16/2010

Expiration Date

06/30/2010

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/08/2010