GOPI MANOHAR PONNAGANTI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065107

License Status

EXPIRED

Business

Title

First Name

GOPI

Middle

MANOHAR

Last Name

PONNAGANTI

Business Name

GOPI MANOHAR PONNAGANTI MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/19/2017