SASHIDHAR VENKATA GANTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

First Name

SASHIDHAR

Middle

VENKATA

Last Name

GANTA

Suffix

Business Name

SASHIDHAR VENKATA GANTA MD

Original Issue Date

04/02/2002

Effective Date

04/02/2002

Expiration Date

07/31/2008

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008