FARAH NIDA IMAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

Title

First Name

FARAH

Middle

NIDA

Last Name

IMAM

Business Name

FARAH NIDA IMAM MD

Original Issue Date

07/18/2016

Effective Date

08/10/2017

Expiration Date

09/30/2020

City

ORLAND PARK

State

Zip

60467

County

TEXAS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021