PREMALATHA NANDKUMAR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

ACTIVE

Business

First Name

PREMALATHA

Last Name

NANDKUMAR

Suffix

Business Name

PREMALATHA NANDKUMAR MD

Original Issue Date

05/19/1986

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023