PRASANNA VENKATESH KUMAR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

First Name

PRASANNA

Middle

VENKATESH

Last Name

KUMAR

Suffix

Business Name

PRASANNA VENKATESH KUMAR MD

Original Issue Date

07/29/2010

Effective Date

05/12/2011

Expiration Date

07/31/2014

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014