PONNIAH SIVANESAN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036065939

License Status

INACTIVE

Business

First Name

PONNIAH

Last Name

SIVANESAN

Suffix

Business Name

PONNIAH SIVANESAN MD

Original Issue Date

01/18/1983

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

DANVILLE

State

Zip

61832

County

VERMILION

Ever Disciplined

LastModifiedDate

04/07/2011