NANDITHA NAGABHUSHANA MALAKKLA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063873

License Status

CANCELLED

Business

First Name

NANDITHA

Middle

NAGABHUSHANA

Last Name

MALAKKLA

Suffix

Business Name

NANDITHA NAGABHUSHANA MALAKKLA MD

Original Issue Date

06/24/2013

Effective Date

06/24/2013

Expiration Date

06/23/2016

City

AURORA

State

Zip

60504

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014