SHINOJ PATTALI JAYAVALSAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

Title

First Name

SHINOJ

Last Name

PATTALI JAYAVALSAN

Business Name

SHINOJ PATTALI JAYAVALSAN MD

Original Issue Date

03/28/2013

Effective Date

03/28/2013

Expiration Date

07/31/2014

City

GREENFIELD

State

Zip

53220

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014