JULIE J SUNDARAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

ACTIVE

Business

Title

First Name

JULIE

Middle

Last Name

SUNDARAM

Business Name

JULIE J SUNDARAM MD

Original Issue Date

08/01/2024

Effective Date

08/01/2024

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61114

County

BOONE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/16/2024