MAYANDI SIVAGURV Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

OTHER CONTROLLED SUBSTANCE

License Number

097001761

License Status

NOT RENEWED

Business

First Name

MAYANDI

Last Name

SIVAGURV

Business Name

MAYANDI SIVAGURV

Original Issue Date

10/04/2010

Effective Date

10/11/2016

Expiration Date

12/31/2018

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

INDIVIDUAL

Controlled Substance Schedule

II IV

Ever Disciplined

LastModifiedDate

02/21/2019