K M L S T MOORTHI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

K M L S T

Last Name

MOORTHI

Suffix

Business Name

K M L S T MOORTHI MD

Original Issue Date

02/06/2003

Effective Date

02/06/2003

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020