MASTAN RAO INDLAMURI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

Title

First Name

MASTAN

Middle

RAO

Last Name

INDLAMURI

Business Name

MASTAN RAO INDLAMURI MD

Original Issue Date

03/09/2017

Effective Date

05/10/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/10/2023