SASAN MAKIPOUR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

Title

First Name

SASAN

Last Name

MAKIPOUR

Business Name

SASAN MAKIPOUR MD

Original Issue Date

01/07/2019

Effective Date

08/25/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023