AZZA MOHAMED ALI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

ACTIVE

Business

Title

First Name

AZZA

Middle

MOHAMED

Last Name

ALI

Business Name

AZZA MOHAMED ALI MD

Original Issue Date

08/21/2023

Effective Date

08/21/2023

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/21/2023