RADHA S TATINENI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

CANCELLED

Business

First Name

RADHA S

Last Name

TATINENI

Suffix

Business Name

RADHA S TATINENI MD

Original Issue Date

06/03/2004

Effective Date

05/05/2011

Expiration Date

07/31/2014

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014