SHIRIN MANSOOR AHMAD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

SHIRIN

Middle

MANSOOR

Last Name

AHMAD

Suffix

Business Name

SHIRIN MANSOOR AHMAD MD

Original Issue Date

06/06/2007

Effective Date

06/06/2007

Expiration Date

07/31/2008

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PHARM DISTRIBUTOR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011