VENKATA SIVA NAGA PRASAD MANNAVA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

Title

First Name

VENKATA

Middle

SIVA NAGA PRASAD

Last Name

MANNAVA

Business Name

VENKATA SIVA NAGA PRASAD MANNAVA MD

Original Issue Date

04/13/2017

Effective Date

04/13/2017

Expiration Date

09/30/2020

City

ROCKINGHAM

State

Zip

28379

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021