MOHAMMED RAASIQ UL IMAN GANDAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

ACTIVE

Business

Title

First Name

MOHAMMED

Middle

RAASIQ UL IMAN

Last Name

GANDAM

Business Name

MOHAMMED RAASIQ UL IMAN GANDAM MD

Original Issue Date

04/21/2023

Effective Date

04/21/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/16/2023