MYSORE S SHIVARAM MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036052319

License Status

INACTIVE

Business

First Name

MYSORE S

Last Name

SHIVARAM

Suffix

Business Name

MYSORE S SHIVARAM MD

Original Issue Date

01/16/1976

Effective Date

01/16/1976

Expiration Date

07/31/1987

City

MILWAUKEE

State

Zip

53215

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006