FATAH A WALLIZADA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024357

License Status

EXPIRED

Business

First Name

FATAH A

Last Name

WALLIZADA

Business Name

FATAH A WALLIZADA

Original Issue Date

07/01/1989

Effective Date

07/01/1989

Expiration Date

06/30/1992

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006