PHANINDRA GADDIPATI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125079926

License Status

EXPIRED

Business

Title

First Name

PHANINDRA

Last Name

GADDIPATI

Business Name

PHANINDRA GADDIPATI MD

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2023

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/06/2024