PAVAN KUMAR TIYYAGURA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

Title

First Name

PAVAN

Middle

KUMAR

Last Name

TIYYAGURA

Business Name

PAVAN KUMAR TIYYAGURA MD

Original Issue Date

09/08/2014

Effective Date

06/01/2017

Expiration Date

09/30/2020

City

HAZEL CREST

State

Zip

60429

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021