SHIMOGA RAMAIAH PRAKASH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

Title

First Name

SHIMOGA

Middle

RAMAIAH

Last Name

PRAKASH

Business Name

SHIMOGA RAMAIAH PRAKASH MD

Original Issue Date

03/24/2025

Effective Date

03/24/2025

Expiration Date

07/31/2026

City

AVON

State

Zip

46123

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/24/2025