SMITHA SURAVARAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

ACTIVE

Business

Title

First Name

SMITHA

Last Name

SURAVARAM

Business Name

SMITHA SURAVARAM MD

Original Issue Date

08/05/2011

Effective Date

09/30/2023

Expiration Date

07/31/2026

City

SOUTHLAKE

State

Zip

76092

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/30/2023