FAUZIA G KHATTAK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

ACTIVE

Business

First Name

FAUZIA

Middle

Last Name

KHATTAK

Suffix

Business Name

FAUZIA G KHATTAK MD

Original Issue Date

08/21/2007

Effective Date

06/21/2023

Expiration Date

07/31/2026

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/21/2023