TAYLOR MITCHELL TABATABAI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071930

License Status

EXPIRED

Business

Title

First Name

TAYLOR

Middle

MITCHELL

Last Name

TABATABAI

Business Name

TAYLOR MITCHELL TABATABAI MD

Original Issue Date

06/26/2018

Effective Date

06/26/2018

Expiration Date

06/25/2019

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/02/2019