SAJIDUL H ANSARI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

NOT RENEWED

Business

First Name

SAJIDUL

Middle

Last Name

ANSARI

Business Name

SAJIDUL H ANSARI

Original Issue Date

09/01/1998

Effective Date

09/01/1998

Expiration Date

07/31/1999

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006