PARVATHY THAIKKENDIYIL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

NOT RENEWED

Business

First Name

PARVATHY

Last Name

THAIKKENDIYIL

Suffix

Business Name

PARVATHY THAIKKENDIYIL MD

Original Issue Date

09/14/2007

Effective Date

07/20/2011

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014