PHANIVARDHAN R BABIREDDY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055722

License Status

CANCELLED

Business

Title

First Name

PHANIVARDHAN

Middle

Last Name

BABIREDDY

Business Name

PHANIVARDHAN R BABIREDDY MD

Original Issue Date

06/16/2009

Effective Date

06/16/2009

Expiration Date

06/15/2012

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/16/2009