ANASUYA S BRAHMAMDAM Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129739

License Status

NOT RENEWED

Business

First Name

ANASUYA

Middle

Last Name

BRAHMAMDAM

Business Name

ANASUYA S BRAHMAMDAM

Original Issue Date

03/07/2012

Effective Date

04/24/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/01/2017