SUSMITHA PUPPALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

First Name

SUSMITHA

Last Name

PUPPALA

Suffix

Business Name

SUSMITHA PUPPALA MD

Original Issue Date

05/16/2008

Effective Date

10/01/2020

Expiration Date

07/31/2023

City

SOUTH BARRINGTON

State

Zip

60010

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023