MYSORE N SHIVARAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036044121

License Status

NOT RENEWED

Business

First Name

MYSORE N

Last Name

SHIVARAM

Suffix

Business Name

MYSORE N SHIVARAM MD

Original Issue Date

03/23/1971

Effective Date

09/14/2020

Expiration Date

07/31/2023

City

OAK BROOK

State

Zip

60523

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/30/2023