PAVANA SREENIVASAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

ACTIVE

Business

Title

First Name

PAVANA

Last Name

SREENIVASAN

Business Name

PAVANA SREENIVASAN MD

Original Issue Date

11/19/2024

Effective Date

11/19/2024

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/19/2024