SURESH KUMAR MANICKAVEL 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

SURESH KUMAR

Last Name

MANICKAVEL

Business Name

SURESH KUMAR MANICKAVEL MD

Original Issue Date

02/17/2017

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

CENTRALIA

State

Zip

62801

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/09/2025