POONAM PRAKASH BHATIA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

CANCELLED

Business

First Name

POONAM

Middle

PRAKASH

Last Name

BHATIA

Suffix

Business Name

POONAM PRAKASH BHATIA MD

Original Issue Date

03/08/2000

Effective Date

03/08/2000

Expiration Date

07/31/2002

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006