SHWETHA MALLESARA SUDHAKAR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056057

License Status

CANCELLED

Business

Title

First Name

SHWETHA

Last Name

MALLESARA SUDHAKAR

Business Name

SHWETHA MALLESARA SUDHAKAR MD

Original Issue Date

06/15/2009

Effective Date

06/15/2009

Expiration Date

06/14/2012

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/14/2009