SUSEELA SAMUDRALA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

CANCELLED

Business

First Name

SUSEELA

Last Name

SAMUDRALA

Suffix

Business Name

SUSEELA SAMUDRALA MD

Original Issue Date

12/24/2001

Effective Date

07/30/2008

Expiration Date

07/31/2011

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011