SHOBA THEIVANAYAGAM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052380

License Status

CANCELLED

Business

Title

First Name

SHOBA

Last Name

THEIVANAYAGAM

Business Name

SHOBA THEIVANAYAGAM MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

IOWA CITY

State

Zip

52245

County

JOHNSON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/25/2007