MEHER B MEDAVARAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

ACTIVE

Business

First Name

MEHER B

Last Name

MEDAVARAM

Suffix

Business Name

MEHER B MEDAVARAM MD

Original Issue Date

07/30/1993

Effective Date

06/29/2023

Expiration Date

07/31/2026

City

BOLINGBROOK

State

Zip

60440

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/29/2023