DEEPTI ANNAPUR SHIVAKUMAR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

ACTIVE

Business

Title

First Name

DEEPTI

Middle

ANNAPUR

Last Name

SHIVAKUMAR

Business Name

DEEPTI ANNAPUR SHIVAKUMAR MD

Original Issue Date

08/25/2011

Effective Date

06/06/2023

Expiration Date

07/31/2026

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/06/2023