SHYAM VADLAPATLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

Title

First Name

SHYAM

Last Name

VADLAPATLA

Business Name

SHYAM VADLAPATLA MD

Original Issue Date

06/25/2014

Effective Date

06/25/2014

Expiration Date

07/31/2017

City

EDGEWATER

State

Zip

07020

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017