SANDYA SHIVASHANKAR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

ACTIVE

Business

Title

First Name

SANDYA

Last Name

SHIVASHANKAR

Business Name

SANDYA SHIVASHANKAR MD

Original Issue Date

08/12/2016

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

IRVING

State

Zip

75063

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2023