ANITA MARA DAMODARAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

ACTIVE

Business

Title

First Name

ANITA

Middle

MARA

Last Name

DAMODARAN

Business Name

ANITA MARA DAMODARAN MD

Original Issue Date

03/16/2017

Effective Date

06/23/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/23/2023