ATA MAZAHERI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044376

License Status

EXPIRED

Business

First Name

ATA

Last Name

MAZAHERI

Suffix

Business Name

ATA MAZAHERI MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006