ANIL KUMAR REDDY REDDIVARI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053289

License Status

CANCELLED

Business

Title

First Name

ANIL

Middle

KUMAR REDDY

Last Name

REDDIVARI

Business Name

ANIL KUMAR REDDY REDDIVARI MD

Original Issue Date

06/20/2007

Effective Date

06/20/2007

Expiration Date

06/19/2010

City

DUNLAP

State

Zip

61525

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/15/2007