SHAKTI KUMAR MATTA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036096678

License Status

INACTIVE

Business

First Name

SHAKTI KUMAR

Last Name

MATTA

Suffix

Business Name

SHAKTI KUMAR MATTA MD

Original Issue Date

09/10/1997

Effective Date

09/10/1997

Expiration Date

07/31/1999

City

OTHELLO

State

Zip

99344

County

WASHINGTON

Ever Disciplined

LastModifiedDate

09/20/2006