SREENIVASA R DHARMAVARAM Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

ACTIVE

Business

First Name

SREENIVASA R

Last Name

DHARMAVARAM

Business Name

SREENIVASA R DHARMAVARAM

Original Issue Date

10/01/1996

Effective Date

04/30/2023

Expiration Date

07/31/2026

City

MOKENA

State

Zip

60448

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/30/2023