DAN B MIRZA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

First Name

DAN B

Last Name

MIRZA

Business Name

DAN B MIRZA

Original Issue Date

08/25/1986

Effective Date

08/25/1986

Expiration Date

07/31/2005

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017