MANINDER S GURAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

MANINDER S

Last Name

GURAM

Suffix

Business Name

MANINDER S GURAM MD

Original Issue Date

04/21/1988

Effective Date

04/21/1988

Expiration Date

07/31/1990

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006