DIVAKAR BOMBRANA PAKKALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

DIVAKAR BOMBRANA

Last Name

PAKKALA

Suffix

Business Name

DIVAKAR BOMBRANA PAKKALA MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1987

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006