KRISHNA SUMANTH SIRUGUPPA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

Title

First Name

KRISHNA

Middle

SUMANTH

Last Name

SIRUGUPPA

Business Name

KRISHNA SUMANTH SIRUGUPPA MD

Original Issue Date

02/27/2012

Effective Date

05/20/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/01/2017