RAVILLA LAKSHMIPATHY MAHIDHAR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

RAVILLA

Middle

LAKSHMIPATHY

Last Name

MAHIDHAR

Suffix

Business Name

RAVILLA LAKSHMIPATHY MAHIDHAR MD

Original Issue Date

05/11/2007

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011