BUVANA MANICKAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119261

License Status

NOT RENEWED

Business

First Name

BUVANA

Last Name

MANICKAM

Suffix

Business Name

BUVANA MANICKAM MD

Original Issue Date

08/22/2007

Effective Date

04/11/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014