SRAVANTHI NAGAVALLI 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

SRAVANTHI

Last Name

NAGAVALLI

Business Name

SRAVANTHI NAGAVALLI

Original Issue Date

04/18/2011

Effective Date

05/21/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/21/2023