AMITHA S MUSHYAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

ACTIVE

Business

Title

First Name

AMITHA

Middle

Last Name

MUSHYAM

Business Name

AMITHA S MUSHYAM MD

Original Issue Date

04/08/2008

Effective Date

05/16/2023

Expiration Date

07/31/2026

City

MCHENRY

State

Zip

60051

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/16/2023