AMITHA MADHURI AVASARALA MD

Business Entity
ACTIVE

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****25

ACTIVE

N

MD

AMITHA

MADHURI

AVASARALA

AMITHA MADHURI AVASARALA MD

07/24/2023

07/24/2023

07/31/2026

MAYWOOD

IL

60153

COOK

PRACTITIONER

IV

N

07/24/2023