MANJUSHA ANNA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

Title

First Name

MANJUSHA

Last Name

ANNA

Business Name

MANJUSHA ANNA MD

Original Issue Date

01/22/2016

Effective Date

07/27/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021