GANESH KUMAR NAMACHIVAYAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036117067

License Status

NOT RENEWED

Business

First Name

GANESH

Middle

KUMAR

Last Name

NAMACHIVAYAM

Suffix

Business Name

GANESH KUMAR NAMACHIVAYAM MD

Original Issue Date

10/19/2006

Effective Date

07/21/2011

Expiration Date

07/31/2014

City

RICE LAKE

State

Zip

54868

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/17/2014