LAVANYA BODDU MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

NOT RENEWED

Business

First Name

LAVANYA

Last Name

BODDU

Suffix

Business Name

LAVANYA BODDU MD

Original Issue Date

07/13/2011

Effective Date

04/21/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020