SAMPATH KUMAR CHENNAMANENI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

Title

First Name

SAMPATH

Middle

KUMAR

Last Name

CHENNAMANENI

Business Name

SAMPATH KUMAR CHENNAMANENI MD

Original Issue Date

04/21/2005

Effective Date

06/12/2017

Expiration Date

09/30/2020

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021