SWAPNA DEVANNA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

Title

First Name

SWAPNA

Last Name

DEVANNA

Business Name

SWAPNA DEVANNA MD

Original Issue Date

08/17/2011

Effective Date

06/21/2017

Expiration Date

09/30/2020

City

COLUMBIA

State

Zip

65203

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021