SUPRAJA RAO GULLA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054210

License Status

EXPIRED

Business

Title

First Name

SUPRAJA

Middle

RAO

Last Name

GULLA

Business Name

SUPRAJA RAO GULLA MD

Original Issue Date

07/07/2008

Effective Date

07/07/2008

Expiration Date

07/06/2011

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/30/2011