ESHWAR P GUMIDYALA 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

First Name

ESHWAR P

Last Name

GUMIDYALA

Suffix

Business Name

ESHWAR P GUMIDYALA MD

Original Issue Date

08/19/1996

Effective Date

06/17/2023

Expiration Date

07/31/2026

City

CRYSTAL LAKE

State

Zip

60014

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/17/2023