SHANTA NISHI KANUKOLLU PHD Clinical Psychologist License verification

Business Entity

ACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071008400

License Status

ACTIVE

Business

Title

PHD

First Name

SHANTA

Middle

NISHI

Last Name

KANUKOLLU

Business Name

SHANTA NISHI KANUKOLLU PHD

Original Issue Date

07/31/2012

Effective Date

09/18/2024

Expiration Date

09/30/2026

City

CHICAGO

State

Zip

60602

County

COOK

Ever Disciplined

LastModifiedDate

09/18/2024