KENN VATTATHARA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036172806

License Status

ACTIVE

Business

Title

First Name

KENN

Last Name

VATTATHARA

Business Name

KENN VATTATHARA MD

Original Issue Date

11/19/2024

Effective Date

11/19/2024

Expiration Date

07/31/2026

City

JOHNSON CITY

State

Zip

37604

Ever Disciplined

LastModifiedDate

12/02/2024