MARIAM E BAROUTA KHARZO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

First Name

MARIAM

Middle

E BAROUTA

Last Name

KHARZO

Suffix

Business Name

MARIAM E BAROUTA KHARZO MD

Original Issue Date

11/15/2005

Effective Date

06/11/2014

Expiration Date

07/31/2017

City

GLENDALE

State

Zip

85310

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017