SOUMIYA PRAKASAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

First Name

SOUMIYA

Last Name

PRAKASAM

Suffix

Business Name

SOUMIYA PRAKASAM MD

Original Issue Date

03/05/2010

Effective Date

08/09/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014