FARNAZ MOAZZAM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036557

License Status

EXPIRED

Business

First Name

FARNAZ

Last Name

MOAZZAM

Business Name

FARNAZ MOAZZAM

Original Issue Date

06/10/1997

Effective Date

06/10/1997

Expiration Date

06/30/2000

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006