SUJATA PRAMOD PRABHU MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

Title

First Name

SUJATA

Middle

PRAMOD

Last Name

PRABHU

Business Name

SUJATA PRAMOD PRABHU MD

Original Issue Date

10/03/2012

Effective Date

10/03/2012

Expiration Date

07/31/2014

City

SAN DIEGO

State

Zip

92122

County

CALIFORNIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014