ARVIND J PONNAMBALAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036130307

License Status

NOT RENEWED

Business

Title

First Name

ARVIND

Middle

Last Name

PONNAMBALAM

Business Name

ARVIND J PONNAMBALAM MD

Original Issue Date

05/10/2012

Effective Date

04/10/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/01/2017