LAVANYA BODDU MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

ACTIVE

Business

First Name

LAVANYA

Last Name

BODDU

Suffix

Business Name

LAVANYA BODDU MD

Original Issue Date

07/15/2008

Effective Date

05/09/2023

Expiration Date

07/31/2026

City

CHAMPAIGN

State

Zip

61822

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2023