KHAJA A NASARUDDIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

KHAJA A

Last Name

NASARUDDIN

Suffix

Business Name

KHAJA A NASARUDDIN MD

Original Issue Date

05/13/1996

Effective Date

04/27/2017

Expiration Date

09/30/2020

City

WOODSTOCK

State

Zip

60098

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021