MAMATHA BOLLINENI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

MAMATHA

Last Name

BOLLINENI

Suffix

Business Name

MAMATHA BOLLINENI MD

Original Issue Date

11/02/2007

Effective Date

11/02/2007

Expiration Date

07/31/2008

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011