License holder summary

SHIVPRASAD DATTATRAYA NIKAM is a Graduate Medical Trainee licensed to practice in Pennsylvania. The address on file for SHIVPRASAD DATTATRAYA NIKAM is Wilkes Barre PA 18702. This medical practitioner license is not current. The license was granted 03/22/2005 and expired on 06/30/2007.

Department of State

Board of Medicine

SHIVPRASAD DATTATRAYA NIKAM
Graduate Medical Trainee
License number
MT185461
Date granted
03/22/2005
Date expires
06/30/2007
Class
Graduate Medical Trainee
Status
Expired
Address
Wilkes Barre PA 18702
medicinepa.com
ID 37555212
LAST UPDATED 2024-05-14 08:28:30 UTC

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