RAJU MAYAPA SHANMUGAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129587

License Status

ACTIVE

Business

Title

First Name

RAJU

Middle

MAYAPA

Last Name

SHANMUGAM

Business Name

RAJU MAYAPA SHANMUGAM MD

Original Issue Date

02/09/2012

Effective Date

05/28/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/28/2023