FATAH A WALLIZADA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036083597

License Status

NOT RENEWED

Business

First Name

FATAH A

Last Name

WALLIZADA

Business Name

FATAH A WALLIZADA

Original Issue Date

10/07/1991

Effective Date

10/07/1991

Expiration Date

07/31/1999

City

JACKSONVILLE

State

Zip

32205

County

FLORIDA

Ever Disciplined

LastModifiedDate

09/20/2006