LEELA SIVA SAI DHANEKULA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

ACTIVE

Business

First Name

LEELA SIVA SAI

Last Name

DHANEKULA

Suffix

Business Name

LEELA SIVA SAI DHANEKULA MD

Original Issue Date

10/15/1996

Effective Date

05/06/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/06/2023