AMIR JAVAD MOMTAHEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

Title

First Name

AMIR

Middle

JAVAD

Last Name

MOMTAHEN

Business Name

AMIR JAVAD MOMTAHEN MD

Original Issue Date

08/18/2015

Effective Date

07/14/2017

Expiration Date

09/30/2020

City

MARION

State

Zip

62959

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021