SRINIVAS RAJAMAHANTY Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

ACTIVE

Business

First Name

SRINIVAS

Last Name

RAJAMAHANTY

Business Name

SRINIVAS RAJAMAHANTY

Original Issue Date

06/14/2011

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/09/2023