ANITA PRABHA TAMIRISA DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

ACTIVE

Business

Title

First Name

ANITA

Middle

PRABHA

Last Name

TAMIRISA

Business Name

ANITA PRABHA TAMIRISA DO

Original Issue Date

09/08/2020

Effective Date

05/03/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/03/2023