PADMA PONUGOTI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

ACTIVE

Business

First Name

PADMA

Last Name

PONUGOTI

Suffix

Business Name

PADMA PONUGOTI MD

Original Issue Date

09/24/2001

Effective Date

01/15/2025

Expiration Date

07/31/2026

City

SAVOY

State

Zip

61874

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/15/2025