BOOTHAPURI VENKATESH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

NOT RENEWED

Business

First Name

BOOTHAPURI

Last Name

VENKATESH

Suffix

Business Name

BOOTHAPURI VENKATESH MD

Original Issue Date

04/11/2002

Effective Date

04/11/2002

Expiration Date

07/31/2005

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006