PRABHAKARA SHETTY HEGGUNJE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

PRABHAKARA

Middle

SHETTY

Last Name

HEGGUNJE

Suffix

Business Name

PRABHAKARA SHETTY HEGGUNJE MD

Original Issue Date

02/24/2005

Effective Date

02/24/2005

Expiration Date

07/31/2008

City

CARMI

State

Zip

62821

County

WHITE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008