SIDHARTH VENKATA PURAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036153860

License Status

ACTIVE

Business

Title

First Name

SIDHARTH

Middle

VENKATA

Last Name

PURAM

Business Name

SIDHARTH VENKATA PURAM MD

Original Issue Date

07/28/2020

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63110

Ever Disciplined

LastModifiedDate

04/08/2023