VENKATESWARA PRASAD POOLA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063938

License Status

CANCELLED

Business

Title

First Name

VENKATESWARA

Middle

PRASAD

Last Name

POOLA

Business Name

VENKATESWARA PRASAD POOLA MD

Original Issue Date

06/29/2013

Effective Date

06/29/2013

Expiration Date

06/28/2014

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Colon and Rectal Surgery

Ever Disciplined

LastModifiedDate

03/24/2014