SUDHA PRAVINKUMAR 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

SUDHA

Last Name

PRAVINKUMAR

Suffix

Business Name

SUDHA PRAVINKUMAR MD

Original Issue Date

08/03/2009

Effective Date

04/11/2011

Expiration Date

07/31/2014

City

STREATOR

State

Zip

61364

County

LA SALLE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017