MAIMANAT A NIZAM MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069635

License Status

INACTIVE

Business

First Name

MAIMANAT A

Last Name

NIZAM

Suffix

Business Name

MAIMANAT A NIZAM MD

Original Issue Date

10/15/1984

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/05/2020