GRACE MURICKEN THUNDIYIL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

GRACE

Middle

MURICKEN

Last Name

THUNDIYIL

Suffix

Business Name

GRACE MURICKEN THUNDIYIL MD

Original Issue Date

03/03/1988

Effective Date

03/03/1988

Expiration Date

07/31/1990

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017