MADHU SHREE GUNDAVARAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

First Name

MADHU

Middle

SHREE

Last Name

GUNDAVARAM

Suffix

Business Name

MADHU SHREE GUNDAVARAM MD

Original Issue Date

05/23/2005

Effective Date

05/23/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60640

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020