S NANDKUMAR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

Last Name

NANDKUMAR

Suffix

Business Name

S NANDKUMAR MD

Original Issue Date

01/01/1997

Effective Date

07/15/2014

Expiration Date

07/31/2017

City

SAVOY

State

Zip

61874

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020