POOVILLAM S SUBRAMANIAM-MOOTHATHU MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129052

License Status

INACTIVE

Business

Title

First Name

POOVILLAM

Middle

Last Name

SUBRAMANIAM-MOOTHATHU

Business Name

POOVILLAM S SUBRAMANIAM-MOOTHATHU MD

Original Issue Date

10/03/2011

Effective Date

10/03/2011

Expiration Date

07/31/2014

City

RICHMOND

State

Zip

23229

Ever Disciplined

LastModifiedDate

04/08/2014