SARAH S KHODADADEH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

SARAH

Middle

Last Name

KHODADADEH

Suffix

Business Name

SARAH S KHODADADEH MD

Original Issue Date

07/20/2011

Effective Date

07/20/2011

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014