SHYAM MOHAN PUPPALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

First Name

SHYAM MOHAN

Last Name

PUPPALA

Suffix

Business Name

SHYAM MOHAN PUPPALA MD

Original Issue Date

08/17/1992

Effective Date

08/17/1992

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60634

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020