FAROZAN ISLAM DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044413

License Status

EXPIRED

Business

First Name

FAROZAN

Last Name

ISLAM

Suffix

Business Name

FAROZAN ISLAM DO

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006