SUBBARAO VENKATA DASARI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112306

License Status

NOT RENEWED

Business

First Name

SUBBARAO

Middle

VENKATA

Last Name

DASARI

Suffix

Business Name

SUBBARAO VENKATA DASARI MD

Original Issue Date

09/09/2004

Effective Date

05/20/2014

Expiration Date

07/31/2017

City

FORT WAYNE

State

Zip

46825

County

INDIANA

Ever Disciplined

LastModifiedDate

11/01/2017