MARYAM MOIN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077842

License Status

CANCELLED

Business

Title

First Name

MARYAM

Last Name

MOIN

Business Name

MARYAM MOIN MD

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

08/20/2025

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

08/18/2025