VIJAYA KUMAR MANGUNTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

First Name

VIJAYA KUMAR

Last Name

MANGUNTA

Suffix

Business Name

VIJAYA KUMAR MANGUNTA MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006