SIVAKUMAR SREENIVASAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

NOT RENEWED

Business

First Name

SIVAKUMAR

Last Name

SREENIVASAN

Suffix

DMD

Business Name

SIVAKUMAR SREENIVASAN DMD

Original Issue Date

02/09/1995

Effective Date

02/09/1995

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60647

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/13/2005