S PRASAD TUMMALA 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

S PRASAD

Last Name

TUMMALA

Business Name

S PRASAD TUMMALA

Original Issue Date

01/01/1997

Effective Date

05/01/2017

Expiration Date

09/30/2020

City

BURR RIDGE

State

Zip

60527

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021