SUMAIYA ISLAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

SUMAIYA

Last Name

ISLAM

Suffix

Business Name

SUMAIYA ISLAM MD

Original Issue Date

12/09/2003

Effective Date

07/31/2017

Expiration Date

09/30/2020

City

BELLEVILLE

State

Zip

62221

County

ARIZONA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021