BRIAN REZA POUSTINCHIAN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

REZA

Last Name

POUSTINCHIAN

Business Name

BRIAN REZA POUSTINCHIAN

Original Issue Date

09/21/2012

Effective Date

09/21/2012

Expiration Date

07/31/2014

City

GENEVA

State

Zip

60134

County

KANE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020