SUDHA SRINIVASAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

ACTIVE

Business

First Name

SUDHA

Last Name

SRINIVASAN

Suffix

Business Name

SUDHA SRINIVASAN MD

Original Issue Date

11/29/2010

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2023