MYSORE S SHIVARAM MD - Medical Doctor License in Wisconsin | # 036052319

MYSORE S SHIVARAM MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036052319

License Status

INACTIVE

Business

N

First Name

MYSORE S

Last Name

SHIVARAM

Suffix

MD

Business Name

MYSORE S SHIVARAM MD

Original Issue Date

01/16/1976

Effective Date

01/16/1976

Expiration Date

07/31/1987

State

WI

Ever Disciplined

N

LastModifiedDate

09/20/2006