JAY R PUDUPAKKAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036093411

License Status

NOT RENEWED

Business

First Name

JAY R

Last Name

PUDUPAKKAM

Suffix

Business Name

JAY R PUDUPAKKAM MD

Original Issue Date

07/10/1996

Effective Date

07/10/1996

Expiration Date

07/31/1999

City

CINCINNATI

State

Zip

45242

County

OHIO

Ever Disciplined

LastModifiedDate

09/20/2006