MALLAVARAPU S RAO MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****75

NOT RENEWED

N

MALLAVARAPU

S

RAO

MD

MALLAVARAPU S RAO MD

01/01/1997

04/30/2014

07/31/2017

CAHOKIA

IL

62206

SAINT CLAIR

II III IV V

N

11/01/2017