LISA PUDUSSERI DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

ACTIVE

Business

Title

First Name

LISA

Last Name

PUDUSSERI

Business Name

LISA PUDUSSERI DO

Original Issue Date

10/03/2014

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023