FARDAD MASSOUMI-BAVIL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113276

License Status

NOT RENEWED

Business

First Name

FARDAD

Last Name

MASSOUMI-BAVIL

Suffix

Business Name

FARDAD MASSOUMI-BAVIL MD

Original Issue Date

03/18/2005

Effective Date

06/30/2014

Expiration Date

07/31/2017

City

OAK PARK

State

Zip

60303

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017