KALYAN CHAKRAVARTHI KANDRA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

Title

First Name

KALYAN

Middle

CHAKRAVARTHI

Last Name

KANDRA

Business Name

KALYAN CHAKRAVARTHI KANDRA MD

Original Issue Date

03/15/2019

Effective Date

03/15/2019

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021