RAVI TEJA KODALI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065338

License Status

EXPIRED

Business

Title

First Name

RAVI

Middle

TEJA

Last Name

KODALI

Business Name

RAVI TEJA KODALI MD

Original Issue Date

07/24/2014

Effective Date

07/24/2014

Expiration Date

07/23/2017

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/19/2017