SHIVI S SIVA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

Title

First Name

SHIVI

Middle

Last Name

SIVA

Business Name

SHIVI S SIVA MD

Original Issue Date

07/23/2015

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021