BALA PRAKASH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

Title

First Name

BALA

Last Name

PRAKASH

Business Name

BALA PRAKASH MD

Original Issue Date

08/24/2015

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

CENTRALIA

State

Zip

62801

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021