KALLURI KRISHNA KISHORE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

KALLURI

Middle

KRISHNA

Last Name

KISHORE

Suffix

Business Name

KALLURI KRISHNA KISHORE MD

Original Issue Date

05/06/2008

Effective Date

05/06/2008

Expiration Date

07/31/2011

City

DIXON

State

Zip

61021

County

LEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017