SUSHMA SHIVANANDA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

ACTIVE

Business

Title

First Name

SUSHMA

Last Name

SHIVANANDA

Business Name

SUSHMA SHIVANANDA MD

Original Issue Date

08/14/2025

Effective Date

08/14/2025

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61605

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/30/2025