SUREIN THEIVAKUMAR DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001247

License Status

EXPIRED

Business

Title

First Name

SUREIN

Last Name

THEIVAKUMAR

Business Name

SUREIN THEIVAKUMAR DO

Original Issue Date

08/20/2018

Effective Date

08/20/2018

Expiration Date

09/19/2018

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Sports Medicine (PM&R)

Ever Disciplined

LastModifiedDate

12/04/2018