ENAYATOLLAH OSANLOO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036052838

License Status

NOT RENEWED

Business

First Name

ENAYATOLLAH

Last Name

OSANLOO

Suffix

Business Name

ENAYATOLLAH OSANLOO MD

Original Issue Date

06/10/1976

Effective Date

06/29/2020

Expiration Date

07/31/2023

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/30/2023