S SIVAPRAKASAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

First Name

Last Name

SIVAPRAKASAM

Suffix

Business Name

S SIVAPRAKASAM MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020