TARIKU TADELE GUDURA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

ACTIVE

Business

Title

First Name

TARIKU

Middle

TADELE

Last Name

GUDURA

Business Name

TARIKU TADELE GUDURA MD

Original Issue Date

03/10/2020

Effective Date

07/19/2023

Expiration Date

07/31/2026

City

FISHERS

State

Zip

46038

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/19/2023