SUPRITHA POTTUMARTHI PRASAD MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077968

License Status

CANCELLED

Business

Title

First Name

SUPRITHA

Middle

POTTUMARTHI

Last Name

PRASAD

Business Name

SUPRITHA POTTUMARTHI PRASAD MD

Original Issue Date

06/24/2021

Effective Date

06/24/2021

Expiration Date

06/23/2024

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/10/2021