NIRUPAMA VALLALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

First Name

NIRUPAMA

Last Name

VALLALA

Suffix

Business Name

NIRUPAMA VALLALA MD

Original Issue Date

08/06/2009

Effective Date

07/31/2014

Expiration Date

07/31/2017

City

OTTAWA

State

Zip

61350

County

LA SALLE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020