MASOUD MARK TASLIMI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

ACTIVE

Business

Title

First Name

MASOUD

Middle

MARK

Last Name

TASLIMI

Business Name

MASOUD MARK TASLIMI MD

Original Issue Date

09/27/2021

Effective Date

08/15/2024

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

08/15/2024