SHOBHA RANI NOOKALA 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

First Name

SHOBHA

Middle

RANI

Last Name

NOOKALA

Suffix

Business Name

SHOBHA RANI NOOKALA MD

Original Issue Date

10/15/2003

Effective Date

07/08/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61602

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/08/2023