SRIDHAR BANURU Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

ACTIVE

Business

First Name

SRIDHAR

Last Name

BANURU

Business Name

SRIDHAR BANURU

Original Issue Date

06/27/2006

Effective Date

06/14/2023

Expiration Date

07/31/2026

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/14/2023