SHARAD PARAKKAL MENON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

First Name

SHARAD

Middle

PARAKKAL

Last Name

MENON

Business Name

SHARAD PARAKKAL MENON

Original Issue Date

01/28/1998

Effective Date

01/28/1998

Expiration Date

07/31/2005

City

EAST ST. LOUIS

State

Zip

62201

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006