SAMBASIVAM SUTHAN 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

Title

First Name

SAMBASIVAM

Last Name

SUTHAN

Business Name

SAMBASIVAM SUTHAN MD

Original Issue Date

02/10/2012

Effective Date

02/10/2012

Expiration Date

07/31/2014

City

TROY

State

Zip

62294

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020