MAGESH SUNDARAM 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

Title

First Name

MAGESH

Last Name

SUNDARAM

Business Name

MAGESH SUNDARAM MD

Original Issue Date

06/19/2012

Effective Date

07/18/2017

Expiration Date

09/30/2020

City

SAVOY

State

Zip

61874

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021