SRIVANI SRIDHAR 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

Title

First Name

SRIVANI

Last Name

SRIDHAR

Business Name

SRIVANI SRIDHAR MD

Original Issue Date

05/29/2013

Effective Date

04/26/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/26/2023