INDIRA VAZZALWAR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

ACTIVE

Business

First Name

INDIRA

Last Name

VAZZALWAR

Suffix

Business Name

INDIRA VAZZALWAR MD

Original Issue Date

08/10/2020

Effective Date

06/20/2023

Expiration Date

07/31/2026

City

WAUKEGAN

State

Zip

60085

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/20/2023