DEVAKI SIVASUBRAMANIAM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045184

License Status

EXPIRED

Business

First Name

DEVAKI

Last Name

SIVASUBRAMANIAM

Suffix

Business Name

DEVAKI SIVASUBRAMANIAM MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2004

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006