AVINASH VENKATA MANTRAVADI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053425

License Status

EXPIRED

Business

First Name

AVINASH

Middle

VENKATA

Last Name

MANTRAVADI

Suffix

Business Name

AVINASH VENKATA MANTRAVADI MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2012

City

MAYWOOD

State

Zip

60153

County

INDIANA

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

08/29/2012