RAGHU KONANUR VENKATARAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

Title

First Name

RAGHU

Last Name

KONANUR VENKATARAM

Business Name

RAGHU KONANUR VENKATARAM MD

Original Issue Date

06/13/2013

Effective Date

04/21/2014

Expiration Date

07/31/2017

City

HERRIN

State

Zip

62948

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017