MANOJ SHIVSANKAR AMBALAVANAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036161953

License Status

ACTIVE

Business

Title

First Name

MANOJ

Middle

SHIVSANKAR

Last Name

AMBALAVANAN

Business Name

MANOJ SHIVSANKAR AMBALAVANAN MD

Original Issue Date

08/12/2022

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

04/10/2024