VIJAY RAVI SUBRAMANIAM DO Medical Doctor License verification

VIJAY RAVI SUBRAMANIAM DO

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125085038

License Status

ACTIVE

Business

Title

First Name

VIJAY

Middle

RAVI

Last Name

SUBRAMANIAM

Business Name

VIJAY RAVI SUBRAMANIAM DO

Original Issue Date

07/19/2024

Effective Date

07/19/2024

Expiration Date

07/18/2027

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/20/2024

Case Number

2024005201

Action

Probation

Discipline Start Date

07/18/2024

Discipline Reason

temporary medical permit placed on indefinite probation for a minimum of three years with multiple conditions due to several deficiencies which led to Applicant being placed on academic probation during his residency program at Payton Manning Children's Hospital.