MARDJAN FOROUTAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

ACTIVE

Business

First Name

MARDJAN

Last Name

FOROUTAN

Suffix

Business Name

MARDJAN FOROUTAN MD

Original Issue Date

10/27/2003

Effective Date

07/26/2023

Expiration Date

07/31/2026

City

SYCAMORE

State

Zip

60178

County

DEKALB

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/26/2023