SURESH KRISHNAMOORTHY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

First Name

SURESH

Last Name

KRISHNAMOORTHY

Suffix

Business Name

SURESH KRISHNAMOORTHY MD

Original Issue Date

12/22/1995

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

CENTRALIA

State

Zip

62801

County

MARION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/09/2023