ANITA PRABHA TAMIRISA DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036154102

License Status

ACTIVE

Business

Title

First Name

ANITA

Middle

PRABHA

Last Name

TAMIRISA

Business Name

ANITA PRABHA TAMIRISA DO

Original Issue Date

08/26/2020

Effective Date

05/03/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

Ever Disciplined

LastModifiedDate

05/03/2023