PURNIMA RANI TRIPATHY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

Title

First Name

PURNIMA

Middle

RANI

Last Name

TRIPATHY

Business Name

PURNIMA RANI TRIPATHY MD

Original Issue Date

03/05/2014

Effective Date

05/01/2014

Expiration Date

07/31/2017

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017