FAZAL MOHAMMAD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

First Name

FAZAL

Last Name

MOHAMMAD

Suffix

Business Name

FAZAL MOHAMMAD MD

Original Issue Date

07/30/2009

Effective Date

08/04/2011

Expiration Date

07/31/2014

City

GLENDALE HEIGHTS

State

Zip

60139

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020