SORAYA NOURI-MOGHADDAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

SORAYA

Last Name

NOURI-MOGHADDAM

Suffix

Business Name

SORAYA NOURI-MOGHADDAM MD

Original Issue Date

05/20/2002

Effective Date

05/20/2002

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006