SURYA P MENTA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

ACTIVE

Business

First Name

SURYA

Middle

Last Name

MENTA

Suffix

Business Name

SURYA P MENTA MD

Original Issue Date

05/18/1999

Effective Date

05/11/2023

Expiration Date

07/31/2026

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/11/2023