SIVASUBRAMANIUM VENKATRAMAN BHAVANI 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

Title

First Name

SIVASUBRAMANIUM

Middle

VENKATRAMAN

Last Name

BHAVANI

Business Name

SIVASUBRAMANIUM VENKATRAMAN BHAVANI MD

Original Issue Date

02/19/2016

Effective Date

06/28/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021