SIVARAMAN PRAKASAM - Dentist License in Oregon | # 019029357

SIVARAMAN PRAKASAM

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019029357

License Status

NOT RENEWED

Business

N

First Name

SIVARAMAN

Last Name

PRAKASAM

Business Name

SIVARAMAN PRAKASAM

Original Issue Date

04/24/2013

Effective Date

08/29/2018

Expiration Date

01/31/2022

State

OR

Ever Disciplined

N

LastModifiedDate

05/09/2022