PRABHU S RAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131454

License Status

NOT RENEWED

Business

Title

First Name

PRABHU

Middle

Last Name

RAM

Business Name

PRABHU S RAM MD

Original Issue Date

09/19/2012

Effective Date

09/19/2012

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/17/2014