POTLURI B RAO MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****51

NOT RENEWED

N

POTLURI B

RAO

MD

POTLURI B RAO MD

01/01/1997

05/15/2014

07/31/2017

ROCKFORD

IL

61103

WINNEBAGO

II III IV V

N

11/01/2017