VISWANATHAM SUSARLA 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

First Name

VISWANATHAM

Last Name

SUSARLA

Suffix

Business Name

VISWANATHAM SUSARLA MD

Original Issue Date

01/01/1997

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

ELGIN

State

Zip

60120

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023