MAZEN DIAB MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

ACTIVE

Business

Title

First Name

MAZEN

Last Name

DIAB

Business Name

MAZEN DIAB MD

Original Issue Date

06/04/2014

Effective Date

07/19/2023

Expiration Date

07/31/2026

City

NEW LENOX

State

Zip

60451

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/19/2023