AJAYDAS THALAPPIL MANIKKAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

AJAYDAS

Middle

THALAPPIL

Last Name

MANIKKAN

Suffix

Business Name

AJAYDAS THALAPPIL MANIKKAN MD

Original Issue Date

08/10/2009

Effective Date

09/04/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023