Biographical Information

 

1. Personal Information
First Name
MI
Last Name
Address 1
Address 2
City
State
Zip Code
Phone Numer - - (incl. area code)
Email
Date of Birth (mm)- (dd) - (yyyy)
Sex Female Male
Birth City
Birth State
Birth Country
Marital Status Single Married
Residence Status U.S.A Citizen U.S.A Permanent Resident
2. Educational Background
Undergraduate Institution
Location (city)
Location (state)
Country
Degree
Major
Graduation Date (mm)- (dd) - (yyyy)
3. Employment Background
UT Employment
(past or present)		 Yes No
Beginning Dates (if yes) (mm)- (dd) - (yyyy)
End Dates (if yes) (mm)- (dd) - (yyyy)
Location City (if yes)
Brief Description
4. Research Experience
Past or Present Research Experience Yes No
Beginning Dates (if yes) (mm)- (dd) - (yyyy)
End Dates (if yes) (mm)- (dd) - (yyyy)
Location City (if yes)
Location State (if yes)
Country
Brief Description
Current Research Interests (if known)
5. Confirmation of Information (please check)

I verify that the information provided above is true and complete to the best of my knowledge and belief.

 



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Syamal K. Bhattacharya, Ph.D.

Professor of Surgery, Medicine and Neurology
Executive Director: MSRF Program
956 Court Ave, Suite B318
The University of Tennessee Health Science Center
Memphis, TN 38163

Phone: 901-448-5676
Fax: 901-448-1692
Email:sbhattachary@uthsc.edu