ASHWIN B SHIVAKUMAR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036121336

License Status

NOT RENEWED

Business

First Name

ASHWIN

Middle

Last Name

SHIVAKUMAR

Suffix

Business Name

ASHWIN B SHIVAKUMAR MD

Original Issue Date

06/30/2008

Effective Date

06/30/2008

Expiration Date

07/31/2011

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

11/14/2011