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Prem Srinivas
Prem srinivas
Subramaniyam
Medical doctor
London, United States
Profile Privacy
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Reveal information
Florida Health Care Practitioner Data Portal
Full name
PREM SRINIVAS SUBRAMANIYAM
Job Title
Medical Doctor
Location
London, KY, USA
LIC ID
170691
Current License Expiration Date
31/01/2026
Original Date
10/10/2023
Professional Rank Code
ME
Effective Date
10/10/2023
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
Out of State
Practice Location Address Line 1
410 Lionel Way
Practice Location Address Line 2
Ste 201
Practice Location Address City
DAVENPORT
Practice Location Address State
FL
Practice Location Address Zipcode
33837
Prescribing Indicator
N
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