ANDREW FARZAD NASSERI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

Title

First Name

ANDREW

Middle

FARZAD

Last Name

NASSERI

Business Name

ANDREW FARZAD NASSERI MD

Original Issue Date

10/14/2014

Effective Date

10/14/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017