NAGENDRA V MYNENI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

NAGENDRA V

Last Name

MYNENI

Business Name

NAGENDRA V MYNENI

Original Issue Date

07/15/1997

Effective Date

07/15/1997

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006