SANYA GHOUSUNNISA SIRAJ MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

ACTIVE

Business

Title

First Name

SANYA

Middle

GHOUSUNNISA

Last Name

SIRAJ

Business Name

SANYA GHOUSUNNISA SIRAJ MD

Original Issue Date

12/11/2013

Effective Date

05/23/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/23/2023