ELIZABETH MOOLAMKUNNAM SIMON Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

ACTIVE

Business

First Name

ELIZABETH

Last Name

MOOLAMKUNNAM SIMON

Business Name

ELIZABETH MOOLAMKUNNAM SIMON

Original Issue Date

01/13/2003

Effective Date

08/15/2023

Expiration Date

07/31/2026

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/15/2023