NITHIN VENKATESH EDARA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

ACTIVE

Business

Title

First Name

NITHIN

Middle

VENKATESH

Last Name

EDARA

Business Name

NITHIN VENKATESH EDARA MD

Original Issue Date

07/19/2024

Effective Date

07/19/2024

Expiration Date

07/31/2026

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/19/2024