VIVEK S KANTAYYA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

Title

First Name

VIVEK S

Last Name

KANTAYYA

Business Name

VIVEK S KANTAYYA MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

07/31/2017

City

HARVARD

State

Zip

60033

County

MCHENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017