MALCOLM MARAZBAN VANDREVALA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

ACTIVE

Business

Title

First Name

MALCOLM

Middle

MARAZBAN

Last Name

VANDREVALA

Business Name

MALCOLM MARAZBAN VANDREVALA MD

Original Issue Date

08/25/2023

Effective Date

08/25/2023

Expiration Date

07/31/2026

City

DES PLAINES

State

Zip

60016

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/25/2023