REVATHI SWAMINATHAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

REVATHI

Last Name

SWAMINATHAN

Suffix

Business Name

REVATHI SWAMINATHAN MD

Original Issue Date

09/16/1981

Effective Date

04/27/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61636

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021