EMAN MAZLOUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036143373

License Status

NOT RENEWED

Business

Title

First Name

EMAN

Last Name

MAZLOUM

Business Name

EMAN MAZLOUM MD

Original Issue Date

06/02/2017

Effective Date

06/02/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

48439

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021