ELIZABETH JAMES PUTHENVEETIL Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

ACTIVE

Business

First Name

ELIZABETH

Middle

JAMES

Last Name

PUTHENVEETIL

Business Name

ELIZABETH JAMES PUTHENVEETIL

Original Issue Date

11/15/2002

Effective Date

06/04/2023

Expiration Date

07/31/2026

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/04/2023