BUVANA MANICKAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

First Name

BUVANA

Last Name

MANICKAM

Suffix

Business Name

BUVANA MANICKAM MD

Original Issue Date

08/22/2007

Effective Date

09/25/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011