LATHA RAVI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

LATHA

Last Name

RAVI

Suffix

Business Name

LATHA RAVI MD

Original Issue Date

09/02/1986

Effective Date

06/21/2017

Expiration Date

09/30/2020

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021