SHOBHA SHAMASUNDAR IYENGAR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

ACTIVE

Business

First Name

SHOBHA

Middle

SHAMASUNDAR

Last Name

IYENGAR

Suffix

Business Name

SHOBHA SHAMASUNDAR IYENGAR MD

Original Issue Date

05/19/1997

Effective Date

05/24/2023

Expiration Date

07/31/2026

City

BELVIDERE

State

Zip

61008

County

BOONE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/24/2023