PRAMEELA BOTLA MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****74

NOT RENEWED

N

PRAMEELA

BOTLA

MD

PRAMEELA BOTLA MD

01/01/1997

06/23/2011

07/31/2014

NORTHBROOK

IL

60062

COOK

II III IV V

N

04/08/2014