SUSHMA MEDA RAGHAVENDRA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

NOT RENEWED

Business

First Name

SUSHMA

Middle

MEDA

Last Name

RAGHAVENDRA

Business Name

SUSHMA MEDA RAGHAVENDRA

Original Issue Date

10/04/2006

Effective Date

10/04/2006

Expiration Date

07/31/2008

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020