PRABA NARAYANA REDDY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

CANCELLED

Business

First Name

PRABA

Middle

NARAYANA

Last Name

REDDY

Suffix

Business Name

PRABA NARAYANA REDDY MD

Original Issue Date

05/02/2000

Effective Date

05/02/2000

Expiration Date

07/31/2005

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006