MADHU BUKKASAGARA VIJAYAPPA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

First Name

MADHU

Middle

BUKKASAGARA

Last Name

VIJAYAPPA

Suffix

Business Name

MADHU BUKKASAGARA VIJAYAPPA MD

Original Issue Date

05/06/2009

Effective Date

05/22/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017