TARANNUM MUJTABA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071563

License Status

CANCELLED

Business

Title

First Name

TARANNUM

Last Name

MUJTABA

Business Name

TARANNUM MUJTABA MD

Original Issue Date

07/19/2017

Effective Date

07/19/2017

Expiration Date

07/18/2020

City

WOODRIDGE

State

Zip

60517

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

07/19/2017