NIRUPAMA VALLALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

First Name

NIRUPAMA

Last Name

VALLALA

Suffix

Business Name

NIRUPAMA VALLALA MD

Original Issue Date

04/07/2004

Effective Date

07/19/2011

Expiration Date

07/31/2014

City

OTTAWA

State

Zip

61350

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020