VINODA SHANTHAPPA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

ACTIVE

Business

Title

First Name

VINODA

Last Name

SHANTHAPPA

Business Name

VINODA SHANTHAPPA MD

Original Issue Date

05/15/2006

Effective Date

06/05/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61636

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/05/2023