SANJIV V PRABHU MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055292

License Status

CANCELLED

Business

Title

First Name

SANJIV

Middle

Last Name

PRABHU

Business Name

SANJIV V PRABHU MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

WICHITA

State

Zip

67226

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

06/13/2008