SHARATH K E RENIGUNTALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

Title

First Name

SHARATH

Middle

K E

Last Name

RENIGUNTALA

Business Name

SHARATH K E RENIGUNTALA MD

Original Issue Date

08/28/2017

Effective Date

08/28/2017

Expiration Date

09/30/2020

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021