PRABHU S RAM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057815

License Status

CANCELLED

Business

Title

First Name

PRABHU

Middle

Last Name

RAM

Business Name

PRABHU S RAM MD

Original Issue Date

09/19/2011

Effective Date

09/19/2011

Expiration Date

06/25/2013

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/19/2011