SARAVANAKUMAR MANICKAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

ACTIVE

Business

Title

First Name

SARAVANAKUMAR

Last Name

MANICKAM

Business Name

SARAVANAKUMAR MANICKAM MD

Original Issue Date

11/27/2024

Effective Date

11/27/2024

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/27/2024