MEDA SHASHIKUMAR RAGHAVENDRA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

ACTIVE

Business

First Name

MEDA SHASHIKUMAR

Last Name

RAGHAVENDRA

Suffix

Business Name

MEDA SHASHIKUMAR RAGHAVENDRA MD

Original Issue Date

08/12/1996

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/14/2023