MADHAVI REDDY MANDALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

First Name

MADHAVI

Middle

REDDY

Last Name

MANDALA

Suffix

Business Name

MADHAVI REDDY MANDALA MD

Original Issue Date

07/10/2006

Effective Date

06/03/2008

Expiration Date

07/31/2011

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011