PRASHANTH MAMIDIPALLI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077316

License Status

EXPIRED

Business

Title

First Name

PRASHANTH

Last Name

MAMIDIPALLI

Business Name

PRASHANTH MAMIDIPALLI MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2022

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Neuroradiology

Ever Disciplined

LastModifiedDate

10/11/2022