PURUSHOTHAMA V DASARAJU Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

PURUSHOTHAMA V

Last Name

DASARAJU

Business Name

PURUSHOTHAMA V DASARAJU

Original Issue Date

09/27/1991

Effective Date

09/27/1991

Expiration Date

07/31/1996

City

PAVIN

State

Zip

61944

County

EDGAR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006