KIZHANTHAM S VEDANTHAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

First Name

KIZHANTHAM S

Last Name

VEDANTHAM

Suffix

Business Name

KIZHANTHAM S VEDANTHAM MD

Original Issue Date

01/01/1997

Effective Date

04/30/2014

Expiration Date

07/31/2017

City

VILLA PARK

State

Zip

60181

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017