VIJAYALAKSHMI MUKKAMALLA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059042

License Status

CANCELLED

Business

Title

First Name

VIJAYALAKSHMI

Last Name

MUKKAMALLA

Business Name

VIJAYALAKSHMI MUKKAMALLA MD

Original Issue Date

06/14/2011

Effective Date

06/14/2011

Expiration Date

06/13/2014

City

ROCK ISLAND

State

Zip

61201

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014