NEENA M MUTHYALA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****87

License Status

NOT RENEWED

Business

First Name

NEENA

Middle

Last Name

MUTHYALA

Business Name

NEENA M MUTHYALA

Original Issue Date

04/05/2004

Effective Date

04/05/2004

Expiration Date

03/01/2008

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

02/05/2009