VIJAYA NAMA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

VIJAYA

Last Name

NAMA

Business Name

VIJAYA NAMA

Original Issue Date

03/11/1999

Effective Date

03/11/1999

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