SUBBARAO VENKATA DASARI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

First Name

SUBBARAO

Middle

VENKATA

Last Name

DASARI

Suffix

Business Name

SUBBARAO VENKATA DASARI MD

Original Issue Date

06/19/2015

Effective Date

06/19/2015

Expiration Date

07/31/2017

City

FORT WAYNE

State

Zip

46825

County

INDIANA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017