PRATHEEK S KAKKASSERIL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

NOT RENEWED

Business

Title

First Name

PRATHEEK

Middle

Last Name

KAKKASSERIL

Business Name

PRATHEEK S KAKKASSERIL MD

Original Issue Date

05/25/2010

Effective Date

06/21/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014