SUBHASH K S NAGALLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

Title

First Name

SUBHASH

Middle

K S

Last Name

NAGALLA

Business Name

SUBHASH K S NAGALLA MD

Original Issue Date

07/15/2010

Effective Date

06/08/2011

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61602

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014