GOWRI MANOHARI SUBRAMANIYAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

Title

First Name

GOWRI

Middle

MANOHARI

Last Name

SUBRAMANIYAN

Business Name

GOWRI MANOHARI SUBRAMANIYAN MD

Original Issue Date

06/07/2016

Effective Date

05/31/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/31/2023