HIMABALA MEDASANI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

ACTIVE

Business

Title

First Name

HIMABALA

Last Name

MEDASANI

Business Name

HIMABALA MEDASANI MD

Original Issue Date

12/20/2018

Effective Date

05/31/2023

Expiration Date

07/31/2026

City

NAPERVILLE

State

Zip

60563

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/31/2023