MAILVAGANAM SRIDHARAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

MAILVAGANAM

Last Name

SRIDHARAN

Suffix

Business Name

MAILVAGANAM SRIDHARAN MD

Original Issue Date

12/08/2003

Effective Date

12/08/2003

Expiration Date

07/31/2008

City

PROPHETSTOWN

State

Zip

61277

County

WHITESIDE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011