LAXMAIAH MANCHIKANTI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

CANCELLED

Business

First Name

LAXMAIAH

Last Name

MANCHIKANTI

Suffix

Business Name

LAXMAIAH MANCHIKANTI MD

Original Issue Date

09/05/2000

Effective Date

09/05/2000

Expiration Date

07/31/2002

City

MARION

State

Zip

62959

County

WILLIAMSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020