LALITHA MAMILLA REDDY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

Title

First Name

LALITHA

Middle

MAMILLA

Last Name

REDDY

Business Name

LALITHA MAMILLA REDDY MD

Original Issue Date

07/30/2018

Effective Date

07/30/2018

Expiration Date

09/30/2020

City

MOLINE

State

Zip

61265

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021