VASUDHA MANTRAVADI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

Title

First Name

VASUDHA

Last Name

MANTRAVADI

Business Name

VASUDHA MANTRAVADI MD

Original Issue Date

02/11/2021

Effective Date

02/11/2021

Expiration Date

07/31/2023

City

SAINT LOUIS

State

Zip

63110

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023