License holder summary

RAO V P MANTRAVADI is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for RAO V P MANTRAVADI is 7910 WEST JEFFERSON BLVD., SUITE 110, FORT WAYNE IN 46804. This licensed professional license is current. The license was granted 08/31/1986 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

RAO V P MANTRAVADI
Controlled Substance Registration - Physician
License number
01032697B
Date granted
08/31/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
7910 WEST JEFFERSON BLVD., SUITE 110, FORT WAYNE IN 46804
indianalicensing.org
ID 5854227
LAST UPDATED 2024-03-19 04:07:54 UTC

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