KAMAL MODIR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

KAMAL

Last Name

MODIR

Suffix

Business Name

KAMAL MODIR MD

Original Issue Date

01/01/1997

Effective Date

07/24/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017