SIRESHA K SAMUDRALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

First Name

SIRESHA

Middle

Last Name

SAMUDRALA

Suffix

Business Name

SIRESHA K SAMUDRALA MD

Original Issue Date

01/10/2003

Effective Date

07/21/2011

Expiration Date

07/31/2014

City

GLEN CARBON

State

Zip

62034

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014