MORTEZA FARASAT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

Title

First Name

MORTEZA

Last Name

FARASAT

Business Name

MORTEZA FARASAT MD

Original Issue Date

09/27/2012

Effective Date

06/06/2017

Expiration Date

09/30/2020

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021