SOUMIYA PRAKASAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

First Name

SOUMIYA

Last Name

PRAKASAM

Suffix

Business Name

SOUMIYA PRAKASAM MD

Original Issue Date

08/20/2025

Effective Date

08/20/2025

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/20/2025