SOUMYASRI KAMBHATLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

Title

First Name

SOUMYASRI

Last Name

KAMBHATLA

Business Name

SOUMYASRI KAMBHATLA MD

Original Issue Date

05/13/2022

Effective Date

05/20/2023

Expiration Date

07/31/2026

City

EVERGREEN PARK

State

Zip

60805

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/03/2024