LATHA BALAMUNISWAMY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

ACTIVE

Business

First Name

LATHA

Last Name

BALAMUNISWAMY

Suffix

Business Name

LATHA BALAMUNISWAMY MD

Original Issue Date

10/03/2001

Effective Date

05/04/2023

Expiration Date

07/31/2026

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/04/2023