BASEL IMAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

ACTIVE

Business

Title

First Name

BASEL

Last Name

IMAM

Business Name

BASEL IMAM MD

Original Issue Date

04/11/2018

Effective Date

05/14/2023

Expiration Date

07/31/2026

City

MESA

State

Zip

85210

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/31/2023