DIVAKARA KEDLAYA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

ACTIVE

Business

Title

First Name

DIVAKARA

Last Name

KEDLAYA

Business Name

DIVAKARA KEDLAYA MD

Original Issue Date

10/02/2018

Effective Date

05/25/2023

Expiration Date

07/31/2026

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/25/2023