BAVIKATTE N SHIVAKUMAR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

NOT RENEWED

Business

First Name

BAVIKATTE N

Last Name

SHIVAKUMAR

Suffix

Business Name

BAVIKATTE N SHIVAKUMAR MD

Original Issue Date

01/26/1982

Effective Date

07/17/2017

Expiration Date

09/30/2020

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021