GANESH KUMAR NAMACHIVAYAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

GANESH

Middle

KUMAR

Last Name

NAMACHIVAYAM

Suffix

Business Name

GANESH KUMAR NAMACHIVAYAM MD

Original Issue Date

10/24/2006

Effective Date

07/21/2011

Expiration Date

07/31/2014

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014