AZHAR M KOTHAWALA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

ACTIVE

Business

Title

First Name

AZHAR

Middle

Last Name

KOTHAWALA

Business Name

AZHAR M KOTHAWALA MD

Original Issue Date

06/02/2016

Effective Date

05/29/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/29/2023