SUBRAMANYAM CHITTIVELU Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

ACTIVE

Business

First Name

SUBRAMANYAM

Last Name

CHITTIVELU

Business Name

SUBRAMANYAM CHITTIVELU

Original Issue Date

12/24/2001

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61606

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023