VIJAYA VENKATASUBBARAYA PAVAN KEDAR MUKTHINUTHALAPATI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068368

License Status

EXPIRED

Business

Title

First Name

VIJAYA VENKATASUBBARAYA

Middle

PAVAN KEDAR

Last Name

MUKTHINUTHALAPATI

Business Name

VIJAYA VENKATASUBBARAYA PAVAN KEDAR MUKTHINUTHALAPATI MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/02/2019