LALITHA MAMILLA REDDY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

Title

First Name

LALITHA

Middle

MAMILLA

Last Name

REDDY

Business Name

LALITHA MAMILLA REDDY MD

Original Issue Date

06/07/2017

Effective Date

06/07/2017

Expiration Date

09/30/2020

City

NEW LENOX

State

Zip

60451

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021