SAMBASIVAM SUTHAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

ACTIVE

Business

Title

First Name

SAMBASIVAM

Last Name

SUTHAN

Business Name

SAMBASIVAM SUTHAN MD

Original Issue Date

09/13/2010

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

HIGHLAND

State

Zip

62249

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023