RAVIPRASAD VS KANAKAMEDALA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

CANCELLED

Business

First Name

RAVIPRASAD VS

Last Name

KANAKAMEDALA

Suffix

Business Name

RAVIPRASAD VS KANAKAMEDALA MD

Original Issue Date

05/30/2003

Effective Date

05/30/2003

Expiration Date

07/31/2005

City

TINLEY PARK

State

Zip

60477

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006