POUPAK ZIAEI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

First Name

POUPAK

Last Name

ZIAEI

Suffix

Business Name

POUPAK ZIAEI MD

Original Issue Date

11/29/2004

Effective Date

05/01/2015

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017