License holder summary

PRAKASH SHANKAR BHOOPALAM is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for PRAKASH SHANKAR BHOOPALAM is PRIME TIME PEDIATRICS, 205 N TILLOTSON AVE STE 201B, MUNCIE IN 47304. This licensed professional license is not current. The license was granted 06/04/1999 and expired on 06/30/2001.

Indiana

Professional Licensing Agency

PRAKASH SHANKAR BHOOPALAM
Controlled Substance Registration - Physician
License number
01040631C
Date granted
06/04/1999
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
PRIME TIME PEDIATRICS, 205 N TILLOTSON AVE STE 201B, MUNCIE IN 47304
indianalicensing.org
ID 5899102
LAST UPDATED 2024-04-12 12:35:01 UTC

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