ANUPAMA VALLALA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

ACTIVE

Business

First Name

ANUPAMA

Last Name

VALLALA

Business Name

ANUPAMA VALLALA

Original Issue Date

02/25/2008

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

EAST ALTON

State

Zip

62024

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2023