KRISHNA KANTH REDDY MANDA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

ACTIVE

Business

Title

First Name

KRISHNA

Middle

KANTH REDDY

Last Name

MANDA

Business Name

KRISHNA KANTH REDDY MANDA MD

Original Issue Date

12/10/2014

Effective Date

06/13/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/13/2023