MOMIN SAULAT SIDDIQUE 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

MOMIN

Middle

SAULAT

Last Name

SIDDIQUE

Business Name

MOMIN SAULAT SIDDIQUE MD

Original Issue Date

05/05/2015

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023