SIDDHARTHA DEVARAKONDA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

ACTIVE

Business

Title

First Name

SIDDHARTHA

Last Name

DEVARAKONDA

Business Name

SIDDHARTHA DEVARAKONDA MD

Original Issue Date

01/15/2021

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

BALLWIN

State

Zip

63021

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023