SIVA SANKAR KETHA 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

SIVA

Middle

SANKAR

Last Name

KETHA

Suffix

Business Name

SIVA SANKAR KETHA MD

Original Issue Date

11/17/2005

Effective Date

11/17/2005

Expiration Date

07/31/2008

City

EVANSTON

State

Zip

60202

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011