DIVYASRI GONGIREDDY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

ACTIVE

Business

Title

First Name

DIVYASRI

Last Name

GONGIREDDY

Business Name

DIVYASRI GONGIREDDY MD

Original Issue Date

06/12/2019

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023