SAMUEL NANDAKUMAR PUVENDRAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

CANCELLED

Business

First Name

SAMUEL

Middle

NANDAKUMAR

Last Name

PUVENDRAN

Suffix

Business Name

SAMUEL NANDAKUMAR PUVENDRAN MD

Original Issue Date

05/25/2006

Effective Date

05/25/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008