ANIL KUMAR KRISHNA PATTISAPU MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

ACTIVE

Business

Title

First Name

ANIL KUMAR

Middle

KRISHNA

Last Name

PATTISAPU

Business Name

ANIL KUMAR KRISHNA PATTISAPU MD

Original Issue Date

03/12/2021

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

SOUTHFIELD

State

Zip

48076

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/09/2023