SAMPATH KUMAR CHENNAMANENI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

CANCELLED

Business

Title

First Name

SAMPATH

Middle

KUMAR

Last Name

CHENNAMANENI

Business Name

SAMPATH KUMAR CHENNAMANENI MD

Original Issue Date

04/21/2005

Effective Date

07/28/2014

Expiration Date

07/31/2017

City

HINSDALE

State

Zip

60521

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020