KIRAN KUMAR MALLULA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036125228

License Status

NOT RENEWED

Business

Title

First Name

KIRAN

Middle

KUMAR

Last Name

MALLULA

Business Name

KIRAN KUMAR MALLULA MD

Original Issue Date

03/17/2010

Effective Date

04/05/2011

Expiration Date

07/31/2014

City

OAK PARK

State

Zip

60301

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014