PHANI MADHURI BORRA 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

Title

First Name

PHANI

Middle

MADHURI

Last Name

BORRA

Business Name

PHANI MADHURI BORRA MD

Original Issue Date

07/30/2021

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023