RAJU M MANTENA DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036123337

License Status

NOT RENEWED

Business

First Name

RAJU

Middle

Last Name

MANTENA

Suffix

Business Name

RAJU M MANTENA DO

Original Issue Date

05/04/2009

Effective Date

07/18/2011

Expiration Date

07/31/2014

City

ROSLYN HEIGHTS

State

Zip

11577

County

NEW YORK

Ever Disciplined

LastModifiedDate

11/17/2014