BALAKRISHNA MUNDODI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

First Name

BALAKRISHNA

Last Name

MUNDODI

Suffix

Business Name

BALAKRISHNA MUNDODI MD

Original Issue Date

03/19/2002

Effective Date

06/13/2011

Expiration Date

07/31/2014

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017