SHREEVIDYA VATTAPARAMBIL MENON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

ACTIVE

Business

Title

First Name

SHREEVIDYA

Middle

VATTAPARAMBIL

Last Name

MENON

Business Name

SHREEVIDYA VATTAPARAMBIL MENON DO

Original Issue Date

06/06/2011

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023