License holder summary

ANTARA MALLAMPALLI is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for ANTARA MALLAMPALLI is SOUTHERN INDIANA REHAB HOSPITAL, 3104 BLACKISTON BOULEVARD, New Albany IN 47150. This licensed professional license is not current. The license was granted 12/28/1998 and expired on 06/30/2003.

Indiana

Professional Licensing Agency

ANTARA MALLAMPALLI
Controlled Substance Registration - Physician
License number
01049332B
Date granted
12/28/1998
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
SOUTHERN INDIANA REHAB HOSPITAL, 3104 BLACKISTON BOULEVARD, New Albany IN 47150
indianalicensing.org
ID 5902084
LAST UPDATED 2024-04-19 08:01:58 UTC

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