SUDESH J EBENEZER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

ACTIVE

Business

Title

First Name

SUDESH

Middle

Last Name

EBENEZER

Business Name

SUDESH J EBENEZER MD

Original Issue Date

07/14/2025

Effective Date

07/14/2025

Expiration Date

07/31/2026

City

CARMICHAEL

State

Zip

95608

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/14/2025