KANNAN KANDALLU MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036089765

License Status

INACTIVE

Business

First Name

KANNAN

Last Name

KANDALLU

Suffix

Business Name

KANNAN KANDALLU MD

Original Issue Date

10/05/1994

Effective Date

10/05/1994

Expiration Date

07/31/1999

City

MUNSTER

State

Zip

46321

County

INDIANA

Ever Disciplined

LastModifiedDate

09/20/2006