KUSUMA NIO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036140884

License Status

NOT RENEWED

Business

Title

First Name

KUSUMA

Last Name

NIO

Business Name

KUSUMA NIO MD

Original Issue Date

06/10/2016

Effective Date

05/18/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021