PRASADRAO R KODURI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

PRASADRAO R

Last Name

KODURI

Suffix

Business Name

PRASADRAO R KODURI MD

Original Issue Date

01/01/1997

Effective Date

03/29/2021

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60607

County

MASSACHUSETTS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023