VIJAYALAKSHMI MUKKAMALLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

Title

First Name

VIJAYALAKSHMI

Last Name

MUKKAMALLA

Business Name

VIJAYALAKSHMI MUKKAMALLA MD

Original Issue Date

02/20/2015

Effective Date

06/15/2023

Expiration Date

07/31/2026

City

MOLINE

State

Zip

61265

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/15/2023