PHANIVARDHAN R BABIREDDY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

ACTIVE

Business

Title

First Name

PHANIVARDHAN

Middle

Last Name

BABIREDDY

Business Name

PHANIVARDHAN R BABIREDDY MD

Original Issue Date

03/06/2012

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023