KALYAN GHANTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114964

License Status

NOT RENEWED

Business

First Name

KALYAN

Last Name

GHANTA

Suffix

Business Name

KALYAN GHANTA MD

Original Issue Date

12/09/2005

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

ONALASKA

State

Zip

54650

Ever Disciplined

LastModifiedDate

11/06/2008