KAVITHA KALVAKURI-MEDURU MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

ACTIVE

Business

Title

First Name

KAVITHA

Last Name

KALVAKURI-MEDURU

Business Name

KAVITHA KALVAKURI-MEDURU MD

Original Issue Date

04/12/2012

Effective Date

04/05/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023