LISA PUDUSSERI DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036135453

License Status

ACTIVE

Business

Title

First Name

LISA

Last Name

PUDUSSERI

Business Name

LISA PUDUSSERI DO

Original Issue Date

06/09/2014

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Ever Disciplined

LastModifiedDate

04/18/2023