SUSHMA SHIVANANDA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125082886

License Status

ACTIVE

Business

Title

First Name

SUSHMA

Last Name

SHIVANANDA

Business Name

SUSHMA SHIVANANDA MD

Original Issue Date

07/26/2024

Effective Date

07/26/2024

Expiration Date

07/25/2025

City

PEORIA

State

Zip

61605

Specialty/Qualifier

Hospice and Palliative Medicine

Ever Disciplined

LastModifiedDate

06/21/2024