NIRGUNA THALLA 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

Title

First Name

NIRGUNA

Last Name

THALLA

Business Name

NIRGUNA THALLA MD

Original Issue Date

08/05/2024

Effective Date

08/05/2024

Expiration Date

07/31/2026

City

GURNEE

State

Zip

60031

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/05/2024