RATNAM KOLLURU NOOKALA SANTOSHI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

Title

First Name

RATNAM

Middle

KOLLURU NOOKALA

Last Name

SANTOSHI

Business Name

RATNAM KOLLURU NOOKALA SANTOSHI MD

Original Issue Date

07/07/2021

Effective Date

07/07/2021

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023