SHYAM MOHAN PUPPALA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

ACTIVE

Business

First Name

SHYAM MOHAN

Last Name

PUPPALA

Suffix

Business Name

SHYAM MOHAN PUPPALA MD

Original Issue Date

08/12/1986

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

SOUTH BARRINGTON

State

Zip

60010

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023