SIRISHA SANAMANDRA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059059

License Status

CANCELLED

Business

Title

First Name

SIRISHA

Last Name

SANAMANDRA

Business Name

SIRISHA SANAMANDRA MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014