SHAKTHISHRI KANDASWAMY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066454

License Status

EXPIRED

Business

Title

First Name

SHAKTHISHRI

Last Name

KANDASWAMY

Business Name

SHAKTHISHRI KANDASWAMY MD

Original Issue Date

06/26/2015

Effective Date

06/26/2015

Expiration Date

06/25/2018

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/25/2018