S M GOLAM KIBRIAUL ALAM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

CANCELLED

Business

First Name

S M GOLAM

Middle

KIBRIAUL

Last Name

ALAM

Suffix

Business Name

S M GOLAM KIBRIAUL ALAM MD

Original Issue Date

06/17/2003

Effective Date

06/17/2003

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006