ASHWIN B SHIVAKUMAR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050299

License Status

CANCELLED

Business

First Name

ASHWIN

Middle

Last Name

SHIVAKUMAR

Suffix

Business Name

ASHWIN B SHIVAKUMAR MD

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006