PRAVEEN DANDAMUDI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

First Name

PRAVEEN

Last Name

DANDAMUDI

Suffix

Business Name

PRAVEEN DANDAMUDI MD

Original Issue Date

06/13/2008

Effective Date

04/08/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60601

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020