PRABHU S RAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

Title

First Name

PRABHU

Middle

Last Name

RAM

Business Name

PRABHU S RAM MD

Original Issue Date

09/19/2012

Effective Date

09/19/2012

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014