GHULAM MUJTABA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

NOT RENEWED

Business

Title

First Name

GHULAM

Last Name

MUJTABA

Business Name

GHULAM MUJTABA MD

Original Issue Date

09/28/2017

Effective Date

09/28/2017

Expiration Date

09/30/2020

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021