SHIVAM PRAKASH KALAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

ACTIVE

Business

Title

First Name

SHIVAM

Middle

PRAKASH

Last Name

KALAN

Business Name

SHIVAM PRAKASH KALAN MD

Original Issue Date

04/21/2023

Effective Date

04/21/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/21/2023