PADMALATHA R MOOLE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

First Name

PADMALATHA

Middle

Last Name

MOOLE

Business Name

PADMALATHA R MOOLE

Original Issue Date

10/04/2002

Effective Date

10/04/2002

Expiration Date

07/31/2005

City

MELROSE PARK

State

Zip

60160

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006