ELIATHAMBY KUGANESWARAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

ELIATHAMBY

Last Name

KUGANESWARAN

Suffix

Business Name

ELIATHAMBY KUGANESWARAN MD

Original Issue Date

11/20/2002

Effective Date

06/19/2008

Expiration Date

07/31/2011

City

PEKIN

State

Zip

61554

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020