MALLESWARI S VANGARA 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

First Name

MALLESWARI S

Last Name

VANGARA

Business Name

MALLESWARI S VANGARA

Original Issue Date

01/16/1996

Effective Date

01/16/1996

Expiration Date

07/31/1999

City

LOMBARD

State

Zip

60148

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006