MAMATA RAVIPATI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

ACTIVE

Business

First Name

MAMATA

Last Name

RAVIPATI

Suffix

Business Name

MAMATA RAVIPATI MD

Original Issue Date

08/26/2002

Effective Date

05/05/2023

Expiration Date

07/31/2026

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/05/2023