MOSTAFA MACIDA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036126203

License Status

NOT RENEWED

Business

First Name

MOSTAFA

Last Name

MACIDA

Suffix

Business Name

MOSTAFA MACIDA MD

Original Issue Date

07/06/2010

Effective Date

05/21/2020

Expiration Date

07/31/2023

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

11/30/2023