HORTANCIA G PUTHUMANA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

ACTIVE

Business

First Name

HORTANCIA G

Last Name

PUTHUMANA

Suffix

Business Name

HORTANCIA G PUTHUMANA MD

Original Issue Date

01/01/1997

Effective Date

05/24/2023

Expiration Date

07/31/2026

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/24/2023