GORANTLA GOVINDAIAH MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****35

NOT RENEWED

N

GORANTLA

GOVINDAIAH

MD

GORANTLA GOVINDAIAH MD

01/01/1997

07/31/1996

PORT BYRON

IL

61275

ROCK ISLAND

II III IV V

N

04/05/2020