GITANJALI T SIVASUBRAMANIAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

ACTIVE

Business

Title

First Name

GITANJALI

Middle

Last Name

SIVASUBRAMANIAM

Business Name

GITANJALI T SIVASUBRAMANIAM MD

Original Issue Date

04/11/2014

Effective Date

07/04/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60639

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/04/2023