HASANKI MADARA WARNAKULA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

ACTIVE

Business

Title

First Name

HASANKI

Middle

MADARA

Last Name

WARNAKULA

Business Name

HASANKI MADARA WARNAKULA MD

Original Issue Date

07/31/2023

Effective Date

07/31/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61605

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/31/2023