SHIMOGA RAMAIAH PRAKASH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036172622

License Status

ACTIVE

Business

Title

First Name

SHIMOGA

Middle

RAMAIAH

Last Name

PRAKASH

Business Name

SHIMOGA RAMAIAH PRAKASH MD

Original Issue Date

11/04/2024

Effective Date

11/04/2024

Expiration Date

07/31/2026

City

AVON

State

Zip

46123

Ever Disciplined

LastModifiedDate

11/04/2024