VITTAL V CHAPA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

First Name

VITTAL V

Last Name

CHAPA

Business Name

VITTAL V CHAPA

Original Issue Date

07/07/1987

Effective Date

05/15/2020

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62711

County

MACOUPIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023