JAGANNADHA RAO AVASARALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

NOT RENEWED

Business

Title

First Name

JAGANNADHA

Middle

RAO

Last Name

AVASARALA

Business Name

JAGANNADHA RAO AVASARALA MD

Original Issue Date

09/15/2014

Effective Date

09/15/2014

Expiration Date

07/31/2017

City

SIMPSONVILLE

State

Zip

29681

County

SOUTH CAROLINA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017