REZA SAM BORHANI DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040949

License Status

EXPIRED

Business

First Name

REZA

Middle

SAM

Last Name

BORHANI

Suffix

Business Name

REZA SAM BORHANI DO

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

06/30/2003

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006