The holder whose full name is MAKKALA, VENKATESHWARA,come from Fort Lee NJ,hold the Physician license(NO.01046540A) which status is Expired Non-Renewable.
| Name | MAKKALA, VENKATESHWARA |
|---|---|
| License Number | 01046540A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Fort Lee |
| State | NJ |