VIVEKA BODDIPALLI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

ACTIVE

Business

Title

First Name

VIVEKA

Last Name

BODDIPALLI

Business Name

VIVEKA BODDIPALLI MD

Original Issue Date

06/29/2012

Effective Date

05/19/2023

Expiration Date

07/31/2026

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/19/2023