PREMRAJ MAKKUNI MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****43

NOT RENEWED

N

MD

PREMRAJ

MAKKUNI

PREMRAJ MAKKUNI MD

04/26/2010

05/31/2017

09/30/2020

ROCKFORD

IL

61104

WINNEBAGO

PRACTITIONER

II III IV V

N

01/14/2021