GOVARDHAN REDDY BOBBALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

GOVARDHAN

Middle

REDDY

Last Name

BOBBALA

Suffix

Business Name

GOVARDHAN REDDY BOBBALA MD

Original Issue Date

07/29/2009

Effective Date

04/12/2011

Expiration Date

07/31/2014

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014