PONDA JAMIL MADATI 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

PONDA

Middle

JAMIL

Last Name

MADATI

Business Name

PONDA JAMIL MADATI MD

Original Issue Date

07/30/2022

Effective Date

06/27/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/27/2023