KAVYA SHIVARAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125086214

License Status

ACTIVE

Business

Title

First Name

KAVYA

Last Name

SHIVARAM

Business Name

KAVYA SHIVARAM MD

Original Issue Date

06/26/2025

Effective Date

06/26/2025

Expiration Date

06/25/2028

City

SPRINGFIELD

State

Zip

62701

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

06/04/2025