SHAFAGH MOTTAGHIAN MONAZZAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

NOT RENEWED

Business

Title

First Name

SHAFAGH

Middle

MOTTAGHIAN

Last Name

MONAZZAM

Business Name

SHAFAGH MOTTAGHIAN MONAZZAM MD

Original Issue Date

04/02/2018

Effective Date

04/02/2018

Expiration Date

09/30/2020

City

SACRAMENTO

State

Zip

95817

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021