SRIDHAR JATLA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

CANCELLED

Business

First Name

SRIDHAR

Last Name

JATLA

Suffix

Business Name

SRIDHAR JATLA MD

Original Issue Date

03/23/2007

Effective Date

03/23/2007

Expiration Date

07/31/2008

City

DEKALB

State

Zip

60115

County

DEKALB

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008