DEDEEPYA KONUTHULA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

ACTIVE

Business

Title

First Name

DEDEEPYA

Last Name

KONUTHULA

Business Name

DEDEEPYA KONUTHULA MD

Original Issue Date

06/16/2022

Effective Date

04/21/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/21/2023