KRISHNA KUMAR GANNAMANENI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

KRISHNA

Middle

KUMAR

Last Name

GANNAMANENI

Suffix

Business Name

KRISHNA KUMAR GANNAMANENI MD

Original Issue Date

09/11/2000

Effective Date

09/11/2000

Expiration Date

07/31/2005

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006