SIVASHANKAR SIVARAMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

First Name

SIVASHANKAR

Last Name

SIVARAMAN

Suffix

Business Name

SIVASHANKAR SIVARAMAN MD

Original Issue Date

06/14/2010

Effective Date

06/28/2017

Expiration Date

09/30/2020

City

BOLINGBROOK

State

Zip

60490

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021