PRAVEEN V PARVATHALA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

ACTIVE

Business

First Name

PRAVEEN

Middle

Last Name

PARVATHALA

Business Name

PRAVEEN V PARVATHALA

Original Issue Date

11/20/2002

Effective Date

07/17/2023

Expiration Date

07/31/2026

City

DOWNERS GROVE

State

Zip

60515

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/17/2023