MANZOOR A TARIQ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

MANZOOR

Middle

Last Name

TARIQ

Suffix

Business Name

MANZOOR A TARIQ MD

Original Issue Date

09/06/1988

Effective Date

08/09/2017

Expiration Date

09/30/2020

City

RED BUD

State

Zip

62278

County

RANDOLPH

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021