SRINIVAS B MUKKAMALA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

First Name

SRINIVAS

Middle

Last Name

MUKKAMALA

Business Name

SRINIVAS B MUKKAMALA

Original Issue Date

06/22/1998

Effective Date

06/22/1998

Expiration Date

07/31/2002

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006