PRAVEENA USHA JAIDEV MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

ACTIVE

Business

Title

First Name

PRAVEENA

Middle

USHA

Last Name

JAIDEV

Business Name

PRAVEENA USHA JAIDEV MD

Original Issue Date

10/19/2017

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023