MOSTAFA MACIDA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055592

License Status

CANCELLED

Business

First Name

MOSTAFA

Last Name

MACIDA

Suffix

Business Name

MOSTAFA MACIDA MD

Original Issue Date

12/17/2008

Effective Date

12/17/2008

Expiration Date

12/16/2010

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/30/2011