SAMEENA SULTANA WAFA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

SAMEENA

Middle

SULTANA

Last Name

WAFA

Suffix

Business Name

SAMEENA SULTANA WAFA MD

Original Issue Date

10/13/2005

Effective Date

10/13/2005

Expiration Date

07/31/2008

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/06/2008