SRIDHAR BHASKARA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

SRIDHAR

Last Name

BHASKARA

Suffix

Business Name

SRIDHAR BHASKARA MD

Original Issue Date

05/03/2000

Effective Date

06/05/2017

Expiration Date

09/30/2020

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021