PETER J PUTHENVEETIL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

First Name

PETER

Middle

Last Name

PUTHENVEETIL

Suffix

Business Name

PETER J PUTHENVEETIL MD

Original Issue Date

12/31/2002

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

PARK CITY

State

Zip

60085

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023