GANESH N PULLA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

First Name

GANESH N

Last Name

PULLA

Business Name

GANESH N PULLA

Original Issue Date

05/17/1994

Effective Date

08/01/2023

Expiration Date

07/31/2026

City

KENOSHA

State

Zip

53142

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/01/2023