ABHISTA VALLABHANENI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

ACTIVE

Business

Title

First Name

ABHISTA

Last Name

VALLABHANENI

Business Name

ABHISTA VALLABHANENI MD

Original Issue Date

07/10/2015

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/14/2023