NIDA SUBHANI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

NIDA

Last Name

SUBHANI

Suffix

Business Name

NIDA SUBHANI MD

Original Issue Date

04/28/2010

Effective Date

07/17/2017

Expiration Date

09/30/2020

City

CENTRALIA

State

Zip

62801

County

MARION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021