BALAJI SHANMUGAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

ACTIVE

Business

Title

First Name

BALAJI

Last Name

SHANMUGAM

Business Name

BALAJI SHANMUGAM MD

Original Issue Date

05/22/2025

Effective Date

05/22/2025

Expiration Date

07/31/2026

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/22/2025