SHANTALA S SREERAMA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

First Name

SHANTALA

Middle

Last Name

SREERAMA

Business Name

SHANTALA S SREERAMA

Original Issue Date

10/27/1997

Effective Date

07/29/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60643

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/29/2023