RAVI PRAKASH KODALI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

RAVI

Middle

PRAKASH

Last Name

KODALI

Suffix

Business Name

RAVI PRAKASH KODALI MD

Original Issue Date

06/08/1998

Effective Date

06/08/1998

Expiration Date

07/31/2005

City

OAK LAWN

State

Zip

60453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006