MINI SIVADASAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

ACTIVE

Business

Title

First Name

MINI

Last Name

SIVADASAN

Business Name

MINI SIVADASAN MD

Original Issue Date

08/31/2010

Effective Date

08/04/2023

Expiration Date

07/31/2026

City

DALLAS

State

Zip

75225

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/04/2023