VENKAT R MANTHA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

NOT RENEWED

Business

First Name

VENKAT

Middle

Last Name

MANTHA

Suffix

Business Name

VENKAT R MANTHA MD

Original Issue Date

01/03/2002

Effective Date

01/03/2002

Expiration Date

07/31/2005

City

AURORA

State

Zip

60504

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006