LATHA MARIYAPPA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

ACTIVE

Business

First Name

LATHA

Last Name

MARIYAPPA

Suffix

Business Name

LATHA MARIYAPPA MD

Original Issue Date

12/02/2003

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

VILLA PARK

State

Zip

60181

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023