SHINOJ PATTALI JAYAVALSAN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036132154

License Status

INACTIVE

Business

Title

First Name

SHINOJ

Last Name

PATTALI JAYAVALSAN

Business Name

SHINOJ PATTALI JAYAVALSAN MD

Original Issue Date

03/28/2013

Effective Date

03/28/2013

Expiration Date

07/31/2014

City

GREENFIELD

State

Zip

53220

Ever Disciplined

LastModifiedDate

04/08/2014