VIJAYA S M SANGORAM 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

VIJAYA S M

Last Name

SANGORAM

Suffix

Business Name

VIJAYA S M SANGORAM MD

Original Issue Date

01/01/1997

Effective Date

05/15/2014

Expiration Date

07/31/2017

City

LINDENHURST

State

Zip

60046

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017