CHAMPA R GOWDA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

First Name

CHAMPA

Middle

Last Name

GOWDA

Suffix

Business Name

CHAMPA R GOWDA MD

Original Issue Date

05/19/2003

Effective Date

05/15/2008

Expiration Date

07/31/2011

City

PEORIA

State

Zip

61636

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011