SRUTHI SAMALA DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036159835

License Status

ACTIVE

Business

Title

First Name

SRUTHI

Last Name

SAMALA

Business Name

SRUTHI SAMALA DO

Original Issue Date

03/18/2022

Effective Date

04/09/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

04/09/2023