OM PRAKASH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124454

License Status

NOT RENEWED

Business

First Name

Last Name

PRAKASH

Suffix

Business Name

OM PRAKASH MD

Original Issue Date

10/05/2009

Effective Date

10/05/2009

Expiration Date

07/31/2011

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/14/2011