GEETHA SIVASUBRAMANIAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

First Name

GEETHA

Last Name

SIVASUBRAMANIAN

Suffix

Business Name

GEETHA SIVASUBRAMANIAN MD

Original Issue Date

04/19/2010

Effective Date

06/21/2017

Expiration Date

09/30/2020

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021