SUJATA PRAMOD PRABHU MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131536

License Status

INACTIVE

Business

Title

First Name

SUJATA

Middle

PRAMOD

Last Name

PRABHU

Business Name

SUJATA PRAMOD PRABHU MD

Original Issue Date

10/03/2012

Effective Date

10/03/2012

Expiration Date

07/31/2014

City

MAYSVILLE

State

Zip

41056

County

KENTUCKY

Ever Disciplined

LastModifiedDate

04/08/2014