PRAVEEN KANDULA 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

KANDULA

Suffix

Business Name

PRAVEEN KANDULA MD

Original Issue Date

06/20/2005

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011