SIVAKAMI THAYU Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

ACTIVE

Business

First Name

SIVAKAMI

Last Name

THAYU

Business Name

SIVAKAMI THAYU

Original Issue Date

10/22/2002

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

LAKE ZURICH

State

Zip

60047

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023