PHANI MADHURI BORRA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073179

License Status

EXPIRED

Business

Title

First Name

PHANI

Middle

MADHURI

Last Name

BORRA

Business Name

PHANI MADHURI BORRA MD

Original Issue Date

06/20/2018

Effective Date

06/20/2018

Expiration Date

06/19/2021

City

DIXON

State

Zip

61021

County

LEE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/14/2018