BHARAT KUMAR PUCHAKAYALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

Title

First Name

BHARAT

Middle

KUMAR

Last Name

PUCHAKAYALA

Business Name

BHARAT KUMAR PUCHAKAYALA MD

Original Issue Date

08/03/2009

Effective Date

06/20/2011

Expiration Date

07/31/2014

City

OGLESBY

State

Zip

61348

County

LA SALLE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014