MUSTAFA SYED AZIMUDDIN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070421

License Status

EXPIRED

Business

Title

First Name

MUSTAFA

Middle

SYED

Last Name

AZIMUDDIN

Business Name

MUSTAFA SYED AZIMUDDIN DO

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

LA GRANGE

State

Zip

60525

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

11/19/2020