PRAVEEN SRISATYA NIMMAGADDA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

PRAVEEN SRISATYA

Last Name

NIMMAGADDA

Business Name

PRAVEEN SRISATYA NIMMAGADDA

Original Issue Date

11/12/1997

Effective Date

11/12/1997

Expiration Date

07/31/2005

City

CHESTER

State

Zip

62233

County

RANDOLPH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006