SINA BAHMANYAR Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

INACTIVE

Business

First Name

SINA

Last Name

BAHMANYAR

Business Name

SINA BAHMANYAR

Original Issue Date

03/15/1995

Effective Date

04/24/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/24/2017