KAVITA PERUMAL KRISHNASAMY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

Title

First Name

KAVITA

Middle

PERUMAL

Last Name

KRISHNASAMY

Business Name

KAVITA PERUMAL KRISHNASAMY MD

Original Issue Date

06/06/2012

Effective Date

04/11/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017