SUSHMA MEDA RAGHAVENDRA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

ACTIVE

Business

First Name

SUSHMA

Middle

MEDA

Last Name

RAGHAVENDRA

Business Name

SUSHMA MEDA RAGHAVENDRA

Original Issue Date

09/08/2006

Effective Date

05/18/2023

Expiration Date

07/31/2026

City

BOLINGBROOK

State

Zip

60490

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/18/2023