PRAVEENA TATHINENI DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072610

License Status

CANCELLED

Business

Title

First Name

PRAVEENA

Last Name

TATHINENI

Business Name

PRAVEENA TATHINENI DO

Original Issue Date

06/24/2018

Effective Date

06/24/2018

Expiration Date

06/23/2021

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/08/2018