CHAITANYA K MAMILLAPALLI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

ACTIVE

Business

Title

First Name

CHAITANYA

Middle

Last Name

MAMILLAPALLI

Business Name

CHAITANYA K MAMILLAPALLI MD

Original Issue Date

04/08/2010

Effective Date

05/30/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/30/2023