KULSOOM A KHAN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037237

License Status

EXPIRED

Business

First Name

KULSOOM

Middle

Last Name

KHAN

Business Name

KULSOOM A KHAN

Original Issue Date

01/01/1997

Effective Date

01/01/1997

Expiration Date

10/05/2000

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006