BAVITHIRA ABIVARSHIA DEVASENATHIPATHY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036148068

License Status

NOT RENEWED

Business

Title

First Name

BAVITHIRA

Middle

ABIVARSHIA

Last Name

DEVASENATHIPATHY

Business Name

BAVITHIRA ABIVARSHIA DEVASENATHIPATHY MD

Original Issue Date

01/08/2019

Effective Date

07/07/2020

Expiration Date

07/31/2023

City

EDWARDSVILLE

State

Zip

62025

Ever Disciplined

LastModifiedDate

11/30/2023