NIVEDITHA MUDEGOWDRA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

Title

First Name

NIVEDITHA

Last Name

MUDEGOWDRA

Business Name

NIVEDITHA MUDEGOWDRA MD

Original Issue Date

03/12/2021

Effective Date

03/12/2021

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023