BAKKIAM SUBBIAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

First Name

BAKKIAM

Last Name

SUBBIAH

Suffix

Business Name

BAKKIAM SUBBIAH MD

Original Issue Date

01/01/1997

Effective Date

06/13/2011

Expiration Date

07/31/2014

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014