VENKAT KRISHNA RAJASURYA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

Title

First Name

VENKAT

Middle

KRISHNA

Last Name

RAJASURYA

Business Name

VENKAT KRISHNA RAJASURYA MD

Original Issue Date

04/09/2012

Effective Date

05/19/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62711

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021