BRAHMAMDAM JAGANNADHARAO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

ACTIVE

Business

First Name

BRAHMAMDAM

Last Name

JAGANNADHARAO

Business Name

BRAHMAMDAM JAGANNADHARAO

Original Issue Date

01/01/1997

Effective Date

05/02/2023

Expiration Date

07/31/2026

City

DANVILLE

State

Zip

61832

County

VERMILION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2023