USHASRI KOGANTI

Business Entity
ACTIVE

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****24

ACTIVE

N

USHASRI

KOGANTI

USHASRI KOGANTI

12/03/1997

05/06/2023

07/31/2026

OTTAWA

IL

61350

LA SALLE

II III IV V

N

05/06/2023