MANOJ SUBBARAO WUNNAVA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

First Name

MANOJ

Middle

SUBBARAO

Last Name

WUNNAVA

Business Name

MANOJ SUBBARAO WUNNAVA

Original Issue Date

04/17/2008

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011