SHIVA PRASAD SHASHIDHARAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

ACTIVE

Business

Title

First Name

SHIVA

Middle

PRASAD

Last Name

SHASHIDHARAN

Business Name

SHIVA PRASAD SHASHIDHARAN MD

Original Issue Date

04/01/2015

Effective Date

05/30/2023

Expiration Date

07/31/2026

City

KANKAKEE

State

Zip

60901

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/30/2023