MOHAMMAD ALI KIZILBASH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

ACTIVE

Business

Title

First Name

MOHAMMAD

Middle

ALI

Last Name

KIZILBASH

Business Name

MOHAMMAD ALI KIZILBASH MD

Original Issue Date

05/31/2005

Effective Date

06/27/2023

Expiration Date

07/31/2026

City

MCHENRY

State

Zip

60050

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/27/2023