PURSHOTHAM DAS S GURUJAL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

First Name

PURSHOTHAM DAS S

Last Name

GURUJAL

Suffix

Business Name

PURSHOTHAM DAS S GURUJAL MD

Original Issue Date

01/01/1997

Effective Date

05/08/2014

Expiration Date

07/31/2017

City

SHELBYVILLE

State

Zip

62565

County

SHELBY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017