General Information


Print Official Detailed License Verification

THIS IS NOT AN OFFICIAL DETAILED LICENSE VERIFICATION

New Search
General Information
  • Name:Umamaheswari Chethana Mukkamalla, M.D.
  • Primary Specialty:Diagnostic Radiology
Address Information
  • Mailing Address: 11995 Singletree Lane
  • Address 2: Suite 500
  • City:Eden Prairie
  • State: MN
  • Zip:55344
  • Phone:(952) 595-1100
  • Fax:(612) 294-4920
License Information
  • License Number: E-10441
  • Original Issue Date: 03/17/2017
  • Expiration Date:08/31/2018
  • Basis: Exam
  • License Status: Active
  • License Category: Unlimited
  • License Number: T2017-064
  • Original Issue Date: 03/10/2017
  • Expiration Date:04/07/2017
  • Basis: Exam
  • License Status: Inactive
  • License Category: Temporary
Board History
No Board Minutes on file for this licensee.
No Board Orders on file for this licensee.