RAGHAVENDER BOOTHPUR MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114800

License Status

INACTIVE

Business

First Name

RAGHAVENDER

Last Name

BOOTHPUR

Suffix

Business Name

RAGHAVENDER BOOTHPUR MD

Original Issue Date

10/25/2005

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

SAINT LOUIS

State

Zip

63119

County

MISSOURI

Ever Disciplined

LastModifiedDate

06/09/2011