SANDY M THAKADIYIL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

Title

First Name

SANDY

Middle

Last Name

THAKADIYIL

Business Name

SANDY M THAKADIYIL MD

Original Issue Date

02/18/2015

Effective Date

05/11/2017

Expiration Date

09/30/2020

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021