CHIRANJEEVI PRAMODNATH REDDY SIDDAGUNTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

Title

First Name

CHIRANJEEVI

Middle

PRAMODNATH REDDY

Last Name

SIDDAGUNTA

Business Name

CHIRANJEEVI PRAMODNATH REDDY SIDDAGUNTA MD

Original Issue Date

09/26/2019

Effective Date

09/17/2020

Expiration Date

07/31/2023

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023