DEEPA HESARAGHATTA KUMBAR Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

NOT RENEWED

Business

First Name

DEEPA

Middle

HESARAGHATTA

Last Name

KUMBAR

Business Name

DEEPA HESARAGHATTA KUMBAR

Original Issue Date

07/20/2004

Effective Date

07/20/2004

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020