PRIYA PONNAPULA Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****84

License Status

NOT RENEWED

Business

First Name

PRIYA

Last Name

PONNAPULA

Business Name

PRIYA PONNAPULA

Original Issue Date

07/08/2010

Effective Date

12/09/2010

Expiration Date

01/31/2013

City

SPARTA

State

Zip

62286

County

RANDOLPH

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/20/2013