Indiana
Professional Licensing Agency
Surendranath Mantena
Temporary Medical Doctor Permit
License number
99021081A
Date granted
05/03/2006
Date expires
08/03/2006
Class
Temporary Medical Doctor Permit
Status
Superceded
Address
Carmel IN 46032
indianalicensing.org
ID 6129008
LAST UPDATED 2026-04-03 15:21:27 UTC
LAST UPDATED 2026-04-03 15:21:27 UTC
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