SURAJ BOPANNA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036126456

License Status

ACTIVE

Business

First Name

SURAJ

Last Name

BOPANNA

Suffix

Business Name

SURAJ BOPANNA MD

Original Issue Date

08/10/2010

Effective Date

05/17/2023

Expiration Date

07/31/2026

City

LOVES PARK

State

Zip

61111

County

BOONE

Ever Disciplined

LastModifiedDate

01/20/2024