SAMUEL NANDAKUMAR PUVENDRAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045254

License Status

EXPIRED

Business

First Name

SAMUEL

Middle

NANDAKUMAR

Last Name

PUVENDRAN

Suffix

Business Name

SAMUEL NANDAKUMAR PUVENDRAN MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006