PHANICHARAN ADITYA SISTLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155554

License Status

ACTIVE

Business

Title

First Name

PHANICHARAN

Middle

ADITYA

Last Name

SISTLA

Business Name

PHANICHARAN ADITYA SISTLA MD

Original Issue Date

02/08/2021

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2023