SHOBA THEIVANAYAGAM MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036125213

License Status

INACTIVE

Business

Title

First Name

SHOBA

Last Name

THEIVANAYAGAM

Business Name

SHOBA THEIVANAYAGAM MD

Original Issue Date

03/16/2010

Effective Date

09/08/2020

Expiration Date

07/31/2023

City

IOWA CITY

State

Zip

52245

County

PEORIA

Ever Disciplined

LastModifiedDate

09/08/2020