VITHAL KUSUMA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

First Name

VITHAL

Last Name

KUSUMA

Suffix

Business Name

VITHAL KUSUMA MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

BERWYN

State

Zip

60402

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006