GOTAM TONY VARMA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062266

License Status

CANCELLED

Business

Title

First Name

GOTAM

Middle

TONY

Last Name

VARMA

Business Name

GOTAM TONY VARMA DO

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014