LINE JOHANSEN SRINIVASAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131163

License Status

ACTIVE

Business

Title

First Name

LINE

Middle

JOHANSEN

Last Name

SRINIVASAN

Business Name

LINE JOHANSEN SRINIVASAN MD

Original Issue Date

08/15/2012

Effective Date

05/31/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

LAKE

Ever Disciplined

LastModifiedDate

05/31/2023