KRISHNA MOHAN KANAKADANDILA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

CANCELLED

Business

First Name

KRISHNA

Middle

MOHAN

Last Name

KANAKADANDILA

Suffix

Business Name

KRISHNA MOHAN KANAKADANDILA MD

Original Issue Date

07/22/1999

Effective Date

07/22/1999

Expiration Date

07/31/2002

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020