MITRA B BOODRAM MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036085419

License Status

INACTIVE

Business

First Name

MITRA B

Last Name

BOODRAM

Suffix

Business Name

MITRA B BOODRAM MD

Original Issue Date

09/29/1992

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

MAION

State

Zip

62959

County

MADISON

Ever Disciplined

LastModifiedDate

04/05/2020