FOURUTAN TIM SHAFIEI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155333

License Status

ACTIVE

Business

Title

First Name

FOURUTAN

Middle

TIM

Last Name

SHAFIEI

Business Name

FOURUTAN TIM SHAFIEI MD

Original Issue Date

01/20/2021

Effective Date

07/04/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62711

Ever Disciplined

LastModifiedDate

07/04/2023