PRASHANTHI BOPPANA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

ACTIVE

Business

First Name

PRASHANTHI

Last Name

BOPPANA

Business Name

PRASHANTHI BOPPANA

Original Issue Date

04/17/2000

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

PARKRIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023