PRAKASH SHANKAR BHOOPALAM
Controlled Substance Registration - Physician
Indiana 01040631D Expired
This Indiana license was held by PRAKASH SHANKAR BHOOPALAM. The license is no longer active. It was granted on 05/30/2003 and expired on 10/31/2013
LICENSE DETAILS
- License Number: 01040631D
- Category: CSR-Physician
- Status: Expired
- Date Granted: 05/30/2003 (about 21 years ago)
- Expiry Date: 10/31/2013 (over 10 years ago)
LOCATIONS
A Address
Prime Time Pediatrics, 205 North Tillotson, Muncie IN 47304