PRAMOD VIJAYAGOPAL MENON Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

First Name

PRAMOD

Middle

VIJAYAGOPAL

Last Name

MENON

Business Name

PRAMOD VIJAYAGOPAL MENON

Original Issue Date

05/30/2025

Effective Date

05/30/2025

Expiration Date

07/31/2026

City

COVINGTON

State

Zip

70433

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/30/2025