AVINASH MANTHA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071562

License Status

CANCELLED

Business

Title

First Name

AVINASH

Last Name

MANTHA

Business Name

AVINASH MANTHA MD

Original Issue Date

07/18/2017

Effective Date

07/18/2017

Expiration Date

07/17/2018

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

Geriatric Medicine

Ever Disciplined

LastModifiedDate

07/18/2017