SHYLENDRA BYATARAYA SREENIVASAPPA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

ACTIVE

Business

First Name

SHYLENDRA

Middle

BYATARAYA

Last Name

SREENIVASAPPA

Suffix

Business Name

SHYLENDRA BYATARAYA SREENIVASAPPA MD

Original Issue Date

02/21/2007

Effective Date

05/19/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/19/2023