HARSHA VARDHANA MOOLE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

Title

First Name

HARSHA

Middle

VARDHANA

Last Name

MOOLE

Business Name

HARSHA VARDHANA MOOLE MD

Original Issue Date

07/18/2016

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

LINCOLN

State

Zip

62656

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021