MANUBOLU DIVYA DEVANAND MD 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

MANUBOLU

Middle

DIVYA

Last Name

DEVANAND

Business Name

MANUBOLU DIVYA DEVANAND MD

Original Issue Date

06/09/2022

Effective Date

06/14/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/14/2023