KAVITHA BATHALA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

First Name

KAVITHA

Last Name

BATHALA

Business Name

KAVITHA BATHALA

Original Issue Date

04/12/2002

Effective Date

07/21/2023

Expiration Date

07/31/2026

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/21/2023