ANURADHA SHANMUGHAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

ANURADHA

Last Name

SHANMUGHAM

Suffix

Business Name

ANURADHA SHANMUGHAM MD

Original Issue Date

03/28/2007

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021