PRAVEEN KANDULA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

PRAVEEN

Last Name

KANDULA

Suffix

Business Name

PRAVEEN KANDULA MD

Original Issue Date

08/01/2008

Effective Date

08/01/2008

Expiration Date

07/31/2011

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011