MAHITA BELLAMKONDA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074105

License Status

CANCELLED

Business

Title

First Name

MAHITA

Last Name

BELLAMKONDA

Business Name

MAHITA BELLAMKONDA MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/17/2019