PRAKASH SHANKAR BHOOPALAM
Controlled Substance Registration - Physician
Indiana 01040631C Expired
This Indiana license was held by PRAKASH SHANKAR BHOOPALAM. The license is no longer active. It was granted on 06/04/1999 and expired on 06/30/2001
LICENSE DETAILS
- License Number: 01040631C
- Category: CSR-Physician
- Status: Expired
- Date Granted: 06/04/1999 (about 26 years ago)
- Expiry Date: 06/30/2001 (almost 24 years ago)
LOCATIONS
A Address
PRIME TIME PEDIATRICS, 205 N TILLOTSON AVE STE 201B, MUNCIE IN 47304