License holder summary

PRAVEEN MANNAM is a Graduate Medical Trainee licensed to practice in Pennsylvania. The address on file for PRAVEEN MANNAM is Corvallis OR 97330. This medical practitioner license is not current. The license was granted 06/09/2003 and expired on 06/30/2006.

Department of State

Board of Medicine

PRAVEEN MANNAM
Graduate Medical Trainee
License number
MT182585
Date granted
06/09/2003
Date expires
06/30/2006
Class
Graduate Medical Trainee
Status
Inactive
Address
Corvallis OR 97330
medicinepa.com
ID 37551771
LAST UPDATED 2024-03-23 10:50:58 UTC

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