SHILPA PUPPALA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

SHILPA

Last Name

PUPPALA

Business Name

SHILPA PUPPALA

Original Issue Date

02/08/2005

Effective Date

04/25/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017