PUNITHA SHIVAPRASAD DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036145264

License Status

NOT RENEWED

Business

Title

First Name

PUNITHA

Last Name

SHIVAPRASAD

Business Name

PUNITHA SHIVAPRASAD DO

Original Issue Date

03/08/2018

Effective Date

03/08/2018

Expiration Date

09/30/2020

City

HERRIN

State

Zip

62948

Ever Disciplined

LastModifiedDate

01/14/2021