License holder summary

POONAM SRIVASTAVA is a Medicine - Written Agreement licensed to practice in Pennsylvania. The address on file for POONAM SRIVASTAVA is 1575 NORTH OLD TRAIL Selinsgrove PA 17870. This licensed professional license is not current. The license was granted 12/09/2002.

Pennsylvania

Department of State

POONAM SRIVASTAVA
Medicine - Written Agreement
License number
MX001176
Date granted
12/09/2002
Class
Medicine - Written Agreement
Status
Inactive
Address
1575 NORTH OLD TRAIL Selinsgrove PA 17870
palicensing.org
ID 16665379
LAST UPDATED 2024-02-29 08:46:28 UTC

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