MADHUSUDAN VALLALA 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

MADHUSUDAN

Last Name

VALLALA

Suffix

Business Name

MADHUSUDAN VALLALA MD

Original Issue Date

01/01/1997

Effective Date

08/09/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60605

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021