SHWETHA MALLIKARJUNA MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****78

NOT RENEWED

N

MD

SHWETHA

MALLIKARJUNA

SHWETHA MALLIKARJUNA MD

06/20/2012

06/20/2012

07/31/2014

SPRINGFIELD

IL

62794

SANGAMON

PRACTITIONER

II III IV V

N

11/17/2014