KALYANI GAVINI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

ACTIVE

Business

First Name

KALYANI

Last Name

GAVINI

Suffix

Business Name

KALYANI GAVINI MD

Original Issue Date

10/12/2007

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

CENTREVILLE

State

Zip

62207

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023