SOUJANYA SODAVARAPU MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060184

License Status

CANCELLED

Business

Title

First Name

SOUJANYA

Last Name

SODAVARAPU

Business Name

SOUJANYA SODAVARAPU MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/03/2011