ATA MOTAMEDI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

First Name

ATA

Last Name

MOTAMEDI

Business Name

ATA MOTAMEDI

Original Issue Date

08/29/1996

Effective Date

08/29/1996

Expiration Date

07/31/1999

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006