KAVITHA SHASHIKUMAR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

ACTIVE

Business

Title

First Name

KAVITHA

Last Name

SHASHIKUMAR

Business Name

KAVITHA SHASHIKUMAR MD

Original Issue Date

08/30/2023

Effective Date

08/30/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/30/2023