KIRAN KUMAR MALLULA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

NOT RENEWED

Business

Title

First Name

KIRAN

Middle

KUMAR

Last Name

MALLULA

Business Name

KIRAN KUMAR MALLULA MD

Original Issue Date

03/19/2010

Effective Date

04/20/2011

Expiration Date

07/31/2014

City

OAK PARK

State

Zip

60301

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014