RAJESH GORANTLA GOVINDAIAH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

ACTIVE

Business

First Name

RAJESH

Middle

GORANTLA

Last Name

GOVINDAIAH

Suffix

Business Name

RAJESH GORANTLA GOVINDAIAH MD

Original Issue Date

07/12/2006

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023