TABASSUM Z IMAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

TABASSUM

Middle

Last Name

IMAM

Suffix

Business Name

TABASSUM Z IMAM MD

Original Issue Date

05/19/2003

Effective Date

04/14/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60639

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017