SUJATHA G GOVINDAIAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

First Name

SUJATHA G

Last Name

GOVINDAIAH

Suffix

Business Name

SUJATHA G GOVINDAIAH MD

Original Issue Date

01/01/1997

Effective Date

07/01/2014

Expiration Date

07/31/2017

City

EAST MOLINE

State

Zip

61244

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020