JAYANT JAGANNATHAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

Title

First Name

JAYANT

Last Name

JAGANNATHAN

Business Name

JAYANT JAGANNATHAN MD

Original Issue Date

03/12/2012

Effective Date

03/12/2012

Expiration Date

07/31/2014

City

DETROIT

State

Zip

48201

County

MICHIGAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014